Healthcare Provider Details

I. General information

NPI: 1427265990
Provider Name (Legal Business Name): DAVID ALLAN KRUSE ND LHIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SHEYENNE ST SUITE 3
WEST FARGO ND
58078-1752
US

IV. Provider business mailing address

205 SHEYENNE STREET SUITE 3
WEST FARGO ND
58078-1752
US

V. Phone/Fax

Practice location:
  • Phone: 701-281-8137
  • Fax: 701-281-8137
Mailing address:
  • Phone: 701-281-8137
  • Fax: 701-281-8137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberH-0031
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberH0031
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: