Provider Demographics
NPI:1750486528
Name:KLAPPERICH, DAVID H (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:KLAPPERICH
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 1:400 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-4552
Mailing Address - Country:US
Mailing Address - Phone:952-442-9770
Mailing Address - Fax:952-442-3620
Practice Address - Street 1:2215 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3711
Practice Address - Country:US
Practice Address - Phone:612-775-8861
Practice Address - Fax:952-442-3620
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007845367500000X
MNR078249-6367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN539S1KLOtherBLUE CROSS BLUE SHIELD
HP57497OtherHEALTH PARTNERS
171256OtherUCARE
2001729OtherMEDICA
967551010905OtherPREFERRED ONE
MN927742100Medicaid
MN539S1KLOtherBLUE CROSS BLUE SHIELD
2001729OtherMEDICA