KELLIE DALE CLAUSEN (NPI# 1487616553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487616553 |
Entity Type | Individual |
Full Name | KELLIE DALE CLAUSEN |
Credential | F.N.P. |
Practice Address |
111 S 5th St Douglas WY 82633-2434 |
Practice Telephone | 3073582122 |
Practice Fax Number | 3073587381 |
Mailing Telephone | 3073582122 |
Mailing Fax Number | 3073587381 |
Enumeration Date | 2006-04-04 |
Last Update Date | 2012-01-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
14471-0152 | WY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WY | BLUECROSS AND BLUESHIELD | 313807 | 01 |
WY | 121710100 | 05 |
Street Address |
111 S 5TH ST |
City | DOUGLAS |
State | WY |
Zip Code | 82633-2434 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689670267 | Phillip O Tigert | Physician Assistant | 111 S 5th St, Douglas, WY 82633-2434 | 2005-06-28 |
1972110138 | Melanie Hummert | Physical Therapist | 111 S 5th St, Douglas, WY 82633-2434 | 2020-09-30 |
1467070730 | Jordon Jacklin | Physical Therapist | 111 S 5th St, Douglas, WY 82633-2434 | 2020-07-13 |
1225662216 | Sara Marie Thronburg | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633-2434 | 2020-02-27 |
1902447477 | Amanda Kay Dykes | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633 | 2019-10-04 |
1043867872 | Aaron Bernal | Physical Therapist | 111 S 5th St, Douglas, WY 82633-2434 | 2019-08-26 |
1033765821 | Hannah Williams | Occupational Therapist | 111 S 5th St, Douglas, WY 82633-2434 | 2019-08-16 |
1710457601 | Michael Jeremey Littleton | Emergency Medical Technician, Paramedic | 111 S 5th St, Douglas, WY 82633-2434 | 2018-12-04 |
1275054751 | Shelby Hoskinson | Physical Therapist | 111 S 5th St, Douglas, WY 82633-2434 | 2017-07-05 |
1811447956 | Melissa Renee Bulkley | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633-2434 | 2016-10-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710304399 | A Keeler Family Dental, LLC | Dentist | 1010 E Richards Street, Douglas, WY 82633 | 2014-03-21 |
1578836805 | Dawn Marie Marchak-cundy | Counselor | 1841 Madora Avenue, Douglas, WY 82633 | 2012-02-16 |
1982894739 | Tanisha Crystal Dexter | Pharmacist | 1202 East Richards Street, Douglas, WY 82633 | 2007-07-27 |
1669521324 | Stephan Paul Ediss | Chiropractor | 1330 E. Richards, Douglas, WY 82633 | 2007-01-10 |
1831280221 | Shauna R Kohler | Nurse Anesthetist, Certified Registered | 111 S 5th Street, Douglas, WY 82633 | 2006-09-28 |
1255438651 | County of Converse | Public Health or Welfare | 442 Center, Douglas, WY 82633 | 2006-09-20 |
1104834134 | Mark W Townsend | Dentist | 820 So 10th, Douglas, WY 82633 | 2006-08-04 |
1548206642 | Douglas Care Center, LLC | Skilled Nursing Facility | 1108 Birch, Douglas, WY 82633 | 2006-06-20 |
1023061223 | North Platte Physical Therapy Services Inc | Physical Therapist | Crook Co Memorial Serv Dist, Sundance, WY 82633 | 2006-05-18 |
1235611468 | Jessica Renee Snyder | Social Worker | 1841 Madora Ave, Douglas, WY 82633 | 2018-09-04 |
Find all providers in zip 82633 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013551829 | Taylor Lamar Gibson | Nurse Practitioner | 200 Doctors Dr Ste O, Douglas, GA 31533-2202 | 2019-11-05 |
1952879918 | Monica Nichole Roberts | Nurse Practitioner | 210 Peterson Ave S, Douglas, GA 31533-5237 | 2018-11-08 |
1770058539 | Carlas Paulk | Nurse Practitioner | 28 Tempa Ln, Douglas, GA 31535-4561 | 2018-10-09 |
1053801860 | Brandon Hall | Nurse Practitioner | 903 Ward St W Ste A, Douglas, GA 31533-3536 | 2018-05-16 |
1235508920 | Michelle Martinez Jones | Nurse Practitioner | 200 Doctors Dr Ste S, Douglas, GA 31533-2203 | 2015-09-23 |
1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
1063817872 | Amanda Brulte | Nurse Practitioner | 100 Doctors Dr Ste 104, Douglas, GA 31533-2211 | 2014-10-23 |
1720481500 | La. Donna Spikes | Nurse Practitioner | 208 Grady Ave S, Douglas, GA 31533-2312 | 2014-10-07 |
1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
Find all providers in DOUGLAS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.