Provider Demographics
NPI:1154620664
Name:KRAUTER, ROSEANNE REBECCA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:REBECCA
Last Name:KRAUTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1411
Mailing Address - Country:US
Mailing Address - Phone:415-350-7327
Mailing Address - Fax:
Practice Address - Street 1:801 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1611
Practice Address - Country:US
Practice Address - Phone:650-723-6819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA784516163W00000X
NY615960163W00000X
CA20578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse