Individual
MRS. KELLY MARIE KRAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2062 HIGHWAY 62 W, MOUNTAIN HOME, AR 72653-7656
(870) 425-5464
(870) 425-5465
Mailing address
P.O. BOX 763, MOUNTAIN HOME, AR 72654
(870) 425-5464
(870) 425-5465
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-567
AR
363AM0700X
Medical Physician Assistant
PA-567
AR
Other
Enumeration date
08/11/2014
Last updated
09/29/2022
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