Provider Demographics
NPI:1326505116
Name:KROUSER, NAKIA (LPN)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:KROUSER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MILL ST APT 4
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-6737
Mailing Address - Country:US
Mailing Address - Phone:845-234-9023
Mailing Address - Fax:
Practice Address - Street 1:211 MILL ST APT 4
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-6737
Practice Address - Country:US
Practice Address - Phone:845-234-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374U00000X
NY317065-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide