Provider Demographics
NPI:1023490315
Name:KRAUSE, KATHERINE K (PA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:K
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:K
Other - Last Name:LOHFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 8003
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54912-8003
Mailing Address - Country:US
Mailing Address - Phone:920-996-3200
Mailing Address - Fax:920-738-5787
Practice Address - Street 1:820 E GRANT ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3483
Practice Address - Country:US
Practice Address - Phone:920-831-5050
Practice Address - Fax:920-738-6400
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3566363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant