Healthcare Provider Details

I. General information

NPI: 1710516166
Provider Name (Legal Business Name): KATHERINE KRAUS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 11/17/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9094 E MINERAL CIR STE 100
CENTENNIAL CO
80112-7201
US

IV. Provider business mailing address

9094 E MINERAL CIR STE 100
CENTENNIAL CO
80112-7201
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number041430993
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN.0995774-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: