Provider Demographics
NPI:1174971642
Name:KRAUSE, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64641 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48095-2584
Mailing Address - Country:US
Mailing Address - Phone:586-752-4477
Mailing Address - Fax:586-775-0397
Practice Address - Street 1:64641 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48095-2584
Practice Address - Country:US
Practice Address - Phone:586-752-4477
Practice Address - Fax:586-775-0397
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004963152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist