Healthcare Provider Details

I. General information

NPI: 1104739788
Provider Name (Legal Business Name): JODY LYNN KRUSER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 ASBURY RD STE 205
DUBUQUE IA
52001-2969
US

IV. Provider business mailing address

2728 ASBURY RD STE 205
DUBUQUE IA
52001-2969
US

V. Phone/Fax

Practice location:
  • Phone: 800-592-8097
  • Fax: 847-717-8440
Mailing address:
  • Phone: 800-592-8097
  • Fax: 847-717-8440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number096114
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: