Provider Demographics
NPI:1487221297
Name:KLAUSING, JESSICA DOTY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DOTY
Last Name:KLAUSING
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2454
Mailing Address - Country:US
Mailing Address - Phone:502-417-2115
Mailing Address - Fax:
Practice Address - Street 1:1616 FOREST HILL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2454
Practice Address - Country:US
Practice Address - Phone:502-417-2115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1097974364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care