Provider Demographics
NPI:1922748839
Name:CLAUSEN, DANIEL J (RD, CD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:CLAUSEN
Suffix:
Gender:M
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 COUNTY ROAD NN
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4454
Mailing Address - Country:US
Mailing Address - Phone:262-741-3147
Mailing Address - Fax:262-741-3757
Practice Address - Street 1:1910 COUNTY ROAD NN
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4454
Practice Address - Country:US
Practice Address - Phone:262-741-3147
Practice Address - Fax:262-741-3757
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1070109133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered