Provider Demographics
NPI:1396707410
Name:KRAUTH, DOUGLAS DUANE (CRNA ARNP)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:DUANE
Last Name:KRAUTH
Suffix:
Gender:M
Credentials:CRNA ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 STONEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-7709
Mailing Address - Country:US
Mailing Address - Phone:712-730-0127
Mailing Address - Fax:
Practice Address - Street 1:1525 WEST 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588
Practice Address - Country:US
Practice Address - Phone:712-730-0127
Practice Address - Fax:712-730-0127
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD040615367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered