Provider Demographics
NPI:1740967181
Name:KRAUSE, COURTNEY MARIE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5668 ARBOR CHASE DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3527
Mailing Address - Country:US
Mailing Address - Phone:248-773-9196
Mailing Address - Fax:
Practice Address - Street 1:5668 ARBOR CHASE DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3527
Practice Address - Country:US
Practice Address - Phone:248-773-9196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704360375363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care