Provider Demographics
NPI:1609482058
Name:KRAUS, NOEL (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7421 DOG TROT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1309
Mailing Address - Country:US
Mailing Address - Phone:937-474-9834
Mailing Address - Fax:
Practice Address - Street 1:10506A MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-246-2400
Practice Address - Fax:513-985-2905
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027127363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid