Provider Demographics
NPI:1427817709
Name:CLAUSEN, KATHERINE ANN (CPNP-PC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BYRON RD STE 600
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1072
Mailing Address - Country:US
Mailing Address - Phone:517-579-2009
Mailing Address - Fax:
Practice Address - Street 1:820 BYRON RD STE 600
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1072
Practice Address - Country:US
Practice Address - Phone:517-579-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704329052363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics