Provider Demographics
NPI:1760106470
Name:KRAUSS, KATIE L
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:L
Other - Last Name:KRAUSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6600 FRANKENLUST RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9338
Mailing Address - Country:US
Mailing Address - Phone:989-225-4708
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANKENLUST RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-9338
Practice Address - Country:US
Practice Address - Phone:989-225-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501014503225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist