Provider Demographics
NPI:1154155166
Name:KRAUSE, KATELYN (APN)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MERION RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1336
Mailing Address - Country:US
Mailing Address - Phone:609-220-6906
Mailing Address - Fax:
Practice Address - Street 1:1000 SALEM ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046
Practice Address - Country:US
Practice Address - Phone:609-871-2060
Practice Address - Fax:609-871-5467
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15116800363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner