Provider Demographics
NPI:1528523206
Name:KRAUSE, LONNY DEE (APRN , NP-C)
Entity type:Individual
Prefix:
First Name:LONNY
Middle Name:DEE
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:APRN , NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N. 500 W.
Mailing Address - Street 2:ATTN. CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:
Practice Address - Street 1:1380 E MEDICAL CENTER DR STE 4100
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2156
Practice Address - Country:US
Practice Address - Phone:435-251-2900
Practice Address - Fax:435-251-2901
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9415611-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily