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NPI Code Detail

MEDICARE: MS. NICHOLLE MARIE CRUSE APRN

MEDICARE: MS. NICHOLLE MARIE CRUSE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner53-75933-032KS

General Provider Information

NPI Number : 1336587914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICHOLLE MARIE CRUSE APRN
Provider Business Mailing Address
First Line : 11900 W 135TH ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66221-9400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11900 W 135TH ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66221-9400
Country : US
Telephone Number : 913-814-7003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2013
Last Update Date : 03/17/2018

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