Healthcare Provider Details

I. General information

NPI: 1700234697
Provider Name (Legal Business Name): ELIZABETH KRAUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 BARBARA LOOP SE STE E1
RIO RANCHO NM
87124-1068
US

IV. Provider business mailing address

PO BOX 35114
ALBUQUERQUE NM
87176-5114
US

V. Phone/Fax

Practice location:
  • Phone: 207-831-8981
  • Fax:
Mailing address:
  • Phone: 505-720-9692
  • Fax: 505-883-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-08315
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: