Provider Demographics
NPI:1942045505
Name:CLAUS, ELIZABETH ANN (CHA-I)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:CLAUS
Suffix:
Gender:F
Credentials:CHA-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:KLAWOCK
Mailing Address - State:AK
Mailing Address - Zip Code:99925-0069
Mailing Address - Country:US
Mailing Address - Phone:907-523-4300
Mailing Address - Fax:907-523-4381
Practice Address - Street 1:7300 KLAWOCK-HOLLIS HWY
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925
Practice Address - Country:US
Practice Address - Phone:907-523-4300
Practice Address - Fax:907-523-4381
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK24-1743-I172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker