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Individual

BRANDY LYNN CROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3800 S NATIONAL AVE STE 600, SPRINGFIELD, MO 65807-5249
(417) 875-3000
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003611A
IN
363A00000X
Physician Assistant
Primary
2021004288
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
220092833
MO
Enumeration date
01/12/2021
Last updated
08/10/2022
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