Provider Demographics
NPI:1093168908
Name:KRAUSE, MARY JOSEPHINE (APRN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JOSEPHINE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15292 FRENCH CRK
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-5213
Mailing Address - Country:US
Mailing Address - Phone:586-201-1599
Mailing Address - Fax:586-285-1531
Practice Address - Street 1:385 N LAPEER RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-3610
Practice Address - Country:US
Practice Address - Phone:248-338-5517
Practice Address - Fax:248-628-8495
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIF06162169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily