Basic Information
Provider Information
NPI: 1073983581
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAUSS
FirstName: NANCY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LVN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000A EMELINE AVE
Address2:  
City: SANTA CRUZ
State: CA
PostalCode: 950601900
CountryCode: US
TelephoneNumber: 8314250112
FaxNumber: 8314251847
Practice Location
Address1: 1000A EMELINE AVE
Address2:  
City: SANTA CRUZ
State: CA
PostalCode: 950601900
CountryCode: US
TelephoneNumber: 8314250112
FaxNumber: 8314251847
Other Information
ProviderEnumerationDate: 09/28/2015
LastUpdateDate: 09/28/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000X261463CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


Home