Keith Anthony Krause, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Berlin, WI
NPI 1104813047 · NPPES record last updated Oct 17, 2017
Key facts
- NPI
- 1104813047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 125032 (WI)
- Practice address
- 225 Memorial Dr
Berlin, WI 54923-1243 - Phone
- (920) 361-5538
- NPI assigned
- Oct 5, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125032 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare Medical Center - Berlin, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 125032 | WI | Yes |
Addresses
Primary practice location
225 Memorial Dr
Berlin, WI 54923-1243
Mailing address
PO Box 2759
Appleton, WI 54912-2759
Phone (920) 830-5900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43376200 | Medicaid | WI |
Other providers in Berlin, WI
- Dale E Kanak
- Philip A Keith
- Kristin Klassa
- Diane Marie Klika
- Benjamin John Kozloski
- Stephanie Krause
- Danielle Lynn Krueger
- Lakeside Neurocare Limited
- Lau Chiropractic and Wellness Center, LLC
- Christopher Roger Lau
All providers in Berlin, WI · Certified Registered Nurse Anesthetist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.