Provider Demographics
NPI:1578209086
Name:KRAUS, KENZIE KEVYNE
Entity type:Individual
Prefix:MS
First Name:KENZIE
Middle Name:KEVYNE
Last Name:KRAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8756
Mailing Address - Country:US
Mailing Address - Phone:952-807-1184
Mailing Address - Fax:
Practice Address - Street 1:4842 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-8756
Practice Address - Country:US
Practice Address - Phone:952-807-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-08
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer