Individual
ETHAN KRAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, PMHNP
Contact information
Practice address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3000
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R245793
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/20/2020
Last updated
11/04/2020
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