Healthcare Provider Details

I. General information

NPI: 1588893739
Provider Name (Legal Business Name): ADRIAN KRAUSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADRIAN GASPERUT M.D.

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 SOUTH LEMAY AVENUE SUITE 300
FORT COLLINS CO
80524-3960
US

IV. Provider business mailing address

1107 SOUTH LEMAY AVENUE SUITE 300
FORT COLLINS CO
80524-3960
US

V. Phone/Fax

Practice location:
  • Phone: 970-493-7442
  • Fax: 970-493-2990
Mailing address:
  • Phone: 970-493-7442
  • Fax: 970-493-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301094474
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number60321112
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number53792
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: