Provider Demographics
NPI:1457330193
Name:HRUSKA, JEANETTE (AUD)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:HRUSKA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 CEDAR CROSS ROAD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7704
Mailing Address - Country:US
Mailing Address - Phone:563-588-0506
Mailing Address - Fax:563-588-0451
Practice Address - Street 1:535 CEDAR CROSS ROAD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7704
Practice Address - Country:US
Practice Address - Phone:563-588-0506
Practice Address - Fax:563-588-0451
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00498237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA12389OtherDEAN HEALTH PLAN
IA0202036Medicaid
IA42098297119OtherJOHN DEERE HEALTHCARE
IA42098297119OtherJOHN DEERE HEALTHCARE