Healthcare Provider Details

I. General information

NPI: 1467427914
Provider Name (Legal Business Name): CYNTHIA MAY KRAUSE MSN,ND, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E APPLE AVE
MUSKEGON MI
49442-3406
US

IV. Provider business mailing address

209 E APPLE AVE
MUSKEGON MI
49442-3406
US

V. Phone/Fax

Practice location:
  • Phone: 231-724-4415
  • Fax:
Mailing address:
  • Phone: 231-724-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number4704178844
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: