Provider Demographics
NPI:1962786996
Name:KRAUS, JENELLE ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:JENELLE
Middle Name:ELIZABETH
Last Name:KRAUS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JENELLE
Other - Middle Name:ELIZABETH
Other - Last Name:SAVRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15034 SHANNON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-1795
Mailing Address - Country:US
Mailing Address - Phone:651-322-6603
Mailing Address - Fax:651-322-6608
Practice Address - Street 1:15034 SHANNON PKWY
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-1795
Practice Address - Country:US
Practice Address - Phone:651-322-6603
Practice Address - Fax:651-322-6608
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist