Judi M Kruse, APRN,BC

Individual provider Active NPI Family Nurse Practitioner · Higginsville, MO

NPI 1376625541 · NPPES record last updated Jan 7, 2010

Key facts

NPI
1376625541
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN075514 (MO)
Practice address
1200 W 22ND St
Higginsville, MO 64037-1420
Phone
(660) 584-7751
Fax
(660) 584-8261
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN075514MOMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN075514 MO Yes

Addresses

Primary practice location

1200 W 22ND St
Higginsville, MO 64037-1420

Mailing address

79 Beach Dr
Lake Tapawingo, MO 64015-9686
Phone (816) 803-8542

Other identifiers

IdentifierTypeStateIssuer
428502108MedicaidMO

Other providers in Higginsville, MO

All providers in Higginsville, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.