Provider Demographics
NPI:1083639157
Name:KRAUSE, DANA JANEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:JANEL
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 RAYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-5272
Mailing Address - Country:US
Mailing Address - Phone:816-353-1872
Mailing Address - Fax:816-353-5022
Practice Address - Street 1:6708 RAYTOWN RD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-5272
Practice Address - Country:US
Practice Address - Phone:816-353-1872
Practice Address - Fax:816-353-5022
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006017280152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0185130001OtherDMERC
MO315486308Medicaid
P00474337OtherRAILROAD MEDICARE
P00474337OtherRAILROAD MEDICARE
MO315486308Medicaid