Individual
DEDRA DENISE CROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
75 ROGERS STREET, LEBANON, VA 24266
(276) 889-7621
Mailing address
PO BOX 2347, LEBANON, VA 24266
(276) 889-7621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166531
VA
Other
Enumeration date
10/17/2006
Last updated
09/27/2012
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