Provider Demographics
NPI:1649837709
Name:KRAUSE, PAMELA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:KRAUSE
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 1:485 W B ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-2765
Mailing Address - Country:US
Mailing Address - Phone:775-423-4434
Mailing Address - Fax:775-423-0422
Practice Address - Street 1:485 W B ST
Practice Address - Street 2:SUITE101
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2765
Practice Address - Country:US
Practice Address - Phone:775-423-4434
Practice Address - Fax:775-423-0422
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN85965163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health