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Individual

KATHRYN E KRUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 751-1720
(765) 281-6567
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002332A
IN
363AM0700X
Medical Physician Assistant
10002332A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001120189
ANTHEM PTAN
IN
01
000001144058
ANTHEM PTAN
IN
01
000001278921
ANTHEM PTAN
IN
01
1102500585
ANTHEM PTAN
IN
05
300007719
IN
Enumeration date
10/04/2017
Last updated
02/12/2025
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