Provider Demographics
NPI:1275599730
Name:KRAUTH, STEPHANIE MAXINE (CRNA ARNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MAXINE
Last Name:KRAUTH
Suffix:
Gender:F
Credentials:CRNA ARNP
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:MAXINE
Other - Last Name:BINNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA ARNP
Mailing Address - Street 1:207 STONEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588
Mailing Address - Country:US
Mailing Address - Phone:712-732-8147
Mailing Address - Fax:712-749-5114
Practice Address - Street 1:1525 WEST 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588
Practice Address - Country:US
Practice Address - Phone:712-732-4030
Practice Address - Fax:712-749-5114
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD094044367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA430072062OtherRAILROAD MEDICARE
IA1227876Medicaid
IA42614OtherBCBS
IA1227876Medicaid