Provider Demographics
NPI:1033342019
Name:KLOHN, AUGUST J (CRNA)
Entity Type:Individual
Prefix:
First Name:AUGUST
Middle Name:J
Last Name:KLOHN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GREENLEAVES BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-7018
Mailing Address - Country:US
Mailing Address - Phone:855-300-7525
Mailing Address - Fax:866-300-7525
Practice Address - Street 1:42570 S AIRPORT RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0946
Practice Address - Country:US
Practice Address - Phone:985-510-6135
Practice Address - Fax:985-510-6202
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN103383APO5842367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1893919Medicaid
LA3B436CW36Medicare PIN