Provider Demographics
NPI:1922619584
Name:KRAUS, SHAWN MARIE
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:MARIE
Last Name:KRAUS
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 1:2000 FM 1460 APT 7201
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4478
Mailing Address - Country:US
Mailing Address - Phone:512-809-7139
Mailing Address - Fax:
Practice Address - Street 1:2000 FM 1460 APT 7201
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4478
Practice Address - Country:US
Practice Address - Phone:512-809-7139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily