Provider Demographics
NPI:1275039844
Name:GRAUSE, AUBRIE NICOLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:AUBRIE
Middle Name:NICOLE
Last Name:GRAUSE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:AUBRIE
Other - Middle Name:NICOLE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:DENALI NATIONAL PARK
Mailing Address - State:AK
Mailing Address - Zip Code:99755-0443
Mailing Address - Country:US
Mailing Address - Phone:907-888-6450
Mailing Address - Fax:
Practice Address - Street 1:238.5 PARKS HWY
Practice Address - Street 2:
Practice Address - City:DENALI NATIONAL PARK
Practice Address - State:AK
Practice Address - Zip Code:99755-9975
Practice Address - Country:US
Practice Address - Phone:907-888-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK125327225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist