Provider Demographics
NPI:1174276067
Name:SAWYER KRAUS, ELISE KATHLEEN (RN)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:KATHLEEN
Last Name:SAWYER KRAUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 GRAFTON RD
Mailing Address - Street 2:
Mailing Address - City:TOWNSHEND
Mailing Address - State:VT
Mailing Address - Zip Code:05353-8820
Mailing Address - Country:US
Mailing Address - Phone:802-365-4331
Mailing Address - Fax:
Practice Address - Street 1:185 GRAFTON RD
Practice Address - Street 2:
Practice Address - City:TOWNSHEND
Practice Address - State:VT
Practice Address - Zip Code:05353-8820
Practice Address - Country:US
Practice Address - Phone:603-762-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0111722163W00000X
NH066132-21163W00000X
VT101.0135267363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner