Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 44322 | CO |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 38078 | AZ |
NPI | 1083808265 |
---|---|
Provider Name | Dr. Jennifer Lynn Klauschie |
First Address | Litchfield Park, AZ 85340 |
Second Address | Litchfield Park, AZ 85340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 19/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
337649 | (05) | AZ |
P00625106 | RAILROAD MEDICARE (01) | AZ |