Individual
ANNIE DEKRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
390675
CA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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