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Individual

BRENDA J KRUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1400 E MADISON AVE, SUITE 400A, MANKATO, MN 56001-5473
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9539
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0109920
MEDICA
MN
01
151319
UCARE
MN
01
1662208
AMERICAS PPO
01
41084933956001C171
CHAMPUS
01
66B52KR
BCBS
MN
05
672608900
MN
01
970018304
RR MEDICARE
01
HP31696
HEALTH PARTNERS
MN
01
NA2951025903
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/10/2020
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