Provider Demographics
NPI:1679794242
Name:KRAUS, GENEVIEVE (NP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:KRAUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5700
Mailing Address - Country:US
Mailing Address - Phone:813-654-2273
Mailing Address - Fax:813-654-1384
Practice Address - Street 1:401 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5710
Practice Address - Country:US
Practice Address - Phone:813-654-2273
Practice Address - Fax:813-654-1384
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420523363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012185300Medicaid
FL012185300Medicaid