Provider Demographics
NPI:1801773205
Name:KRUSE, LISA CATHERINE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CATHERINE
Last Name:KRUSE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 16TH ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-3908
Mailing Address - Country:US
Mailing Address - Phone:978-395-6085
Mailing Address - Fax:
Practice Address - Street 1:660 16TH ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-3908
Practice Address - Country:US
Practice Address - Phone:978-395-6085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide