=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619690104
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIAN BRYSON KRAUSE FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2022
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 136 STONEMARK LN STE 100C
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29210-3881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-704-4661
-----------------------------------------------------
Fax | 888-239-2595
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 DEER MEADOW CIR
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28752-2870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-803-1528
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WE0003X
-----------------------------------------------------
Taxonomy Name | Emergency Registered Nurse
-----------------------------------------------------
License Number | 229583
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 30673
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5017084
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------