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General NPI Number Information
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NPI Number | 1184715559
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Entity Type | Individual
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Provider Name | CAROL LEA KRAUSE M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 705 E MAIN AVE STE 300
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City | BISMARCK
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State | ND
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Zip | 58501-4525
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Country | US
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Telephone | 701-255-2453
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Fax | 701-255-2339
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Provider Business Mailing Address
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Address Line | PO BOX 2213
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City | BISMARCK
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State | ND
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Zip | 58502-2213
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Country | US
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Telephone | 701-255-2453
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Fax | 701-255-2339
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 6604
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License Number State | ND
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