Provider Demographics
NPI:1437981040
Name:ALEXANDRA KRAUSE NUTRITION
Entity type:Organization
Organization Name:ALEXANDRA KRAUSE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-627-5532
Mailing Address - Street 1:2223 S HIGHLAND DR STE E6223
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3672
Mailing Address - Country:US
Mailing Address - Phone:919-627-5532
Mailing Address - Fax:
Practice Address - Street 1:2223 S HIGHLAND DR STE E6223
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3672
Practice Address - Country:US
Practice Address - Phone:919-627-5532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty