Provider Demographics
NPI:1568517381
Name:KRAISS, ERIN L
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:KRAISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 TERRILL RD
Mailing Address - Street 2:APT 2
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-3898
Mailing Address - Country:US
Mailing Address - Phone:715-894-0252
Mailing Address - Fax:
Practice Address - Street 1:321 13TH ST SE
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2032
Practice Address - Country:US
Practice Address - Phone:715-323-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program