MEDICARE: DR. DEIRDRE ANNE KRAUSE PH.D., ARNP, BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1049622	FL

General Provider Information

NPI Number	:	1649262874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEIRDRE ANNE KRAUSE PH.D., ARNP, BC

Provider Business Mailing Address
First Line	:	13283 MARCELLA BLVD
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-4965
Country	:	US
Telephone Number	:	561-793-1025
Fax Number	:

Provider Business Practice Location Address
First Line	:	10651 E ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78419-5130
Country	:	US
Telephone Number	:	361-961-6037
Fax Number	:	361-961-6185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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