Provider Demographics
NPI:1457090979
Name:KLAUSING, MATHIAS (RN)
Entity Type:Individual
Prefix:
First Name:MATHIAS
Middle Name:
Last Name:KLAUSING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15659 ROAD 5
Mailing Address - Street 2:
Mailing Address - City:PANDORA
Mailing Address - State:OH
Mailing Address - Zip Code:45877-9748
Mailing Address - Country:US
Mailing Address - Phone:419-890-6624
Mailing Address - Fax:
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-228-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.430317163W00000X
OHAPRN.CNP.0031478363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse