Provider Demographics
NPI:1609994839
Name:CLAES, CAROL JANEECE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JANEECE
Last Name:CLAES
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 1:2674 WHETSTONE RIVER RD S
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-8937
Mailing Address - Country:US
Mailing Address - Phone:740-389-2048
Mailing Address - Fax:
Practice Address - Street 1:2674 WHETSTONE RIVER RD S
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-8937
Practice Address - Country:US
Practice Address - Phone:740-389-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-143775374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2539113Medicaid