Provider Demographics
NPI:1780070169
Name:KRAUSE, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
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 1:3619 SE 30TH TER APT 203
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-4102
Mailing Address - Country:US
Mailing Address - Phone:763-486-2838
Mailing Address - Fax:
Practice Address - Street 1:3619 SE 30TH TER APT 203
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-4102
Practice Address - Country:US
Practice Address - Phone:763-486-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSK03349900390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program