Provider Demographics
NPI:1447070792
Name:KROUSE, THERESA (BSN, RN, FNP-S)
Entity type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:
Last Name:KROUSE
Suffix:
Gender:F
Credentials:BSN, RN, FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 WATER ST PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:JENNERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15547
Mailing Address - Country:US
Mailing Address - Phone:814-279-0071
Mailing Address - Fax:
Practice Address - Street 1:122 WATER ST PO BOX 132
Practice Address - Street 2:
Practice Address - City:JENNERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15547
Practice Address - Country:US
Practice Address - Phone:814-279-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer