Provider Demographics
NPI:1326490954
Name:KRAUSS, MARY BETH (MSN-FNP-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:MSN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 N HOUCKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1808
Mailing Address - Country:US
Mailing Address - Phone:443-790-9502
Mailing Address - Fax:
Practice Address - Street 1:760 N HOUCKSVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1808
Practice Address - Country:US
Practice Address - Phone:443-790-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF1016173363LF0000X
MDR161220390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program