Provider Demographics
NPI:1063735777
Name:CLAUSEN, REBECCA ANN (MS, FNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 BRYANT ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-2006
Mailing Address - Country:US
Mailing Address - Phone:716-878-7109
Mailing Address - Fax:716-716-8883
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-7330
Practice Address - Fax:716-888-3917
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336179-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily