Provider Demographics
NPI:1932860244
Name:KLEUTSCH, ASHLEY (APRN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KLEUTSCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:FRIEDENFELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 S GIBSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-1622
Mailing Address - Country:US
Mailing Address - Phone:715-748-2121
Mailing Address - Fax:
Practice Address - Street 1:135 S GIBSON ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1622
Practice Address - Country:US
Practice Address - Phone:715-748-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11647-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner