Provider Demographics
NPI:1962438499
Name:DRAUS, CATHERINE A (NP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:A
Last Name:DRAUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22060 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2847
Mailing Address - Country:US
Mailing Address - Phone:313-563-3640
Mailing Address - Fax:313-563-0459
Practice Address - Street 1:22060 BEECH ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2847
Practice Address - Country:US
Practice Address - Phone:313-563-3640
Practice Address - Fax:313-563-0459
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704132047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5008600860OtherBLUECROSSBLUESHIELD OF MI
MI4762369Medicaid
MI4762369Medicaid