Provider Demographics
NPI:1053713776
Name:KLAUS, KRISTEN ELAINE (CPNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELAINE
Last Name:KLAUS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:KUEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2234 BLOSSOMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6150
Mailing Address - Country:US
Mailing Address - Phone:407-907-5577
Mailing Address - Fax:
Practice Address - Street 1:2234 BLOSSOMWOOD DR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765
Practice Address - Country:US
Practice Address - Phone:407-907-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990511363LP0200X
FL9384904363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics