Provider Demographics
NPI:1427265990
Name:KRUSE, DAVID ALLAN (ND LHIS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLAN
Last Name:KRUSE
Suffix:
Gender:
Credentials:ND LHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SHEYENNE STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-1752
Mailing Address - Country:US
Mailing Address - Phone:701-281-8137
Mailing Address - Fax:701-281-8137
Practice Address - Street 1:205 SHEYENNE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-1752
Practice Address - Country:US
Practice Address - Phone:701-281-8137
Practice Address - Fax:701-281-8137
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDH-0031174400000X
NDH0031332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN37G80SHOtherMN BLUE CROSSBLUE SHIELD