Provider Demographics
NPI:1255662565
Name:KRAUSS, SISSY LYNN
Entity Type:Individual
Prefix:MRS
First Name:SISSY
Middle Name:LYNN
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SISSY
Other - Middle Name:LYNN
Other - Last Name:KRAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 E 112TH AVE
Mailing Address - Street 2:#80
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4681
Mailing Address - Country:US
Mailing Address - Phone:303-898-1333
Mailing Address - Fax:
Practice Address - Street 1:2829 W 33RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3231
Practice Address - Country:US
Practice Address - Phone:303-433-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO950241813172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
052520OtherCIGNA