Provider Demographics
NPI:1174570097
Name:KRUSE, RUTHANN (DC)
Entity type:Individual
Prefix:DR
First Name:RUTHANN
Middle Name:
Last Name:KRUSE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RUTHANN
Other - Middle Name:
Other - Last Name:KRUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 2048
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-2048
Mailing Address - Country:US
Mailing Address - Phone:480-231-3423
Mailing Address - Fax:480-454-6298
Practice Address - Street 1:29834 N CAVE CREEK RD STE 142
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5837
Practice Address - Country:US
Practice Address - Phone:804-513-8900
Practice Address - Fax:480-454-6298
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2025-02-07
Deactivation Date:2024-11-04
Deactivation Code:
Reactivation Date:2024-11-14
Provider Licenses
StateLicense IDTaxonomies
AZ7185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ71304Medicare ID - Type Unspecified
AZU78275Medicare UPIN