Provider Demographics
NPI:1801917844
Name:KRAUSE, PATRICIA ANN (CNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4783 RUE DE CAROLYN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48370-2239
Mailing Address - Country:US
Mailing Address - Phone:248-709-9071
Mailing Address - Fax:
Practice Address - Street 1:29829 TELEGRAPH RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1330
Practice Address - Country:US
Practice Address - Phone:248-354-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704176153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP90333Medicare UPIN
MIP01240004Medicare PIN