Provider Demographics
NPI:1831231075
Name:KRAUS, ELIZABETH MARY
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY
Last Name:KRAUS
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 1:8150 373RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-5507
Mailing Address - Country:US
Mailing Address - Phone:763-389-4805
Mailing Address - Fax:763-389-4805
Practice Address - Street 1:657 MAIN ST NW
Practice Address - Street 2:STE 214A
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1584
Practice Address - Country:US
Practice Address - Phone:763-218-6185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1145171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist