Provider Demographics
NPI:1366778813
Name:KRAUS, MONIKA DENA (RD, LDN)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:DENA
Last Name:KRAUS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 BUSH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7574
Mailing Address - Country:US
Mailing Address - Phone:919-875-8150
Mailing Address - Fax:919-235-0653
Practice Address - Street 1:3500 BUSH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7574
Practice Address - Country:US
Practice Address - Phone:919-875-8150
Practice Address - Fax:919-235-0653
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003206133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered