Myrtle Jean Krushall, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1882 Issued in CA

Practice address

3838 Sherman Dr
Suite 5
Riverside, CA 92503-4001

Phone

(951) 343-1700

Fax

(951) 343-1777

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paulus Santoso MD a Professional Corporation

  • Obstetrics Physician
  • Riverside, CA
  • NPI 1093042970
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1396957932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-343-1700",
            "fax_number": "951-343-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-343-1700",
            "fax_number": "951-343-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSHALL",
        "first_name": "MYRTLE",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "1882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "221779",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "1882",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Thomas Krouse
• Joseph Theodore Krpalek, PA-C
• Reise Krueger
• Camille Dora Kruger, IMF79417
• Waylan Kruse
• Christina Marie Krysta, NONE
• Joseph K Ku, MD
• Desiree Kua
• Genevieve Luu Kua, PHARMD
• Connie Kuang, PA-C

• Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.