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NPI Code Detail

MEDICARE: MS. GAYLE ANN CLAUSEN PA-C

MEDICARE:  MS. GAYLE ANN CLAUSEN  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant3383AZ

General Provider Information

NPI Number : 1134195746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GAYLE ANN CLAUSEN PA-C
Provider Business Mailing Address
First Line : 1830 MESQUITE AVE
Second Line : SUITE A
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5885
Country : US
Telephone Number : 928-855-8071
Fax Number : 928-855-6869
Provider Business Practice Location Address
First Line : 1830 MESQUITE AVE
Second Line : SUITE A
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5885
Country : US
Telephone Number : 928-855-8071
Fax Number : 928-855-6869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 08/27/2011

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Directions to “ MS. GAYLE ANN CLAUSEN PA-C” Practice Location

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