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NPI Code Detail

MEDICARE: BIANCA KRAUSE

MEDICARE: BIANCA KRAUSE
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
1363A00000XPhysician Assistant14120MN
2363A00000XPhysician Assistant0110011061VA

General Provider Information

NPI Number : 1689310500
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIANCA KRAUSE
Provider Business Mailing Address
First Line : PO BOX 780125
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-0125
Country : US
Telephone Number : 804-922-4844
Fax Number :
Provider Business Practice Location Address
First Line : 1575 BEAM AVE
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1126
Country : US
Telephone Number : 651-232-7348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2022
Last Update Date : 01/27/2026

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Directions to “ BIANCA KRAUSE ” Practice Location

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