Provider Demographics
NPI:1760493720
Name:CLAASSEN, ELIZABETH L (PA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:CLAASSEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8778
Mailing Address - Country:US
Mailing Address - Phone:316-283-6103
Mailing Address - Fax:316-283-1333
Practice Address - Street 1:720 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8778
Practice Address - Country:US
Practice Address - Phone:316-284-5155
Practice Address - Fax:316-284-5110
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS363A00000X
KS00719363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100374080CMedicaid
KS203459OtherHPK
KS100374080AMedicaid
KS042706OtherBCBS
KS12149448OtherMULTIPLAN
KS30004002380003Medicaid
KS9324OtherPHS