Provider Demographics
NPI:1578790192
Name:CLAUDON, TERESA ANN (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:CLAUDON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450B JASPER CT
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-1698
Mailing Address - Country:US
Mailing Address - Phone:920-242-3272
Mailing Address - Fax:
Practice Address - Street 1:450B JASPER CT
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-1698
Practice Address - Country:US
Practice Address - Phone:920-242-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI119791-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse