Healthcare Provider Details

I. General information

NPI: 1316460348
Provider Name (Legal Business Name): PAUL G KRUM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL KRUM CRNA

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 13TH ST
HAVRE MT
59501-5222
US

IV. Provider business mailing address

30 13TH ST
HAVRE MT
59501-5222
US

V. Phone/Fax

Practice location:
  • Phone: 406-265-2211
  • Fax:
Mailing address:
  • Phone: 406-265-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number076240-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: