Provider Demographics
NPI:1679337075
Name:CLAUS, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CLAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3473 OLD HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9687
Mailing Address - Country:US
Mailing Address - Phone:440-477-2999
Mailing Address - Fax:
Practice Address - Street 1:3473 OLD HICKORY LN
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9687
Practice Address - Country:US
Practice Address - Phone:440-477-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker