Doctor Name: | MISS LISA MARIE KRAUSE |
NPI Number: | 1295032928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | C0004711 |
Business Practice Address: | 1200 Brooks Ln Suite G-10 Clairton, PA - 150253747 |
Business Phone Number: | 4124695914 |
Business Fax Number: | 4124697004 |
Mailing Address: | 9720 Barnes Lake Rd, IRWIN |
State: | PA |
Postal Code: | 156423135 |
Phone Number: | 2155279349 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2011 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | C0004711 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |