Healthcare Provider Details

I. General information

NPI: 1194519504
Provider Name (Legal Business Name): MADELINE KLAUER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S LAKE PARK AVE
HOBART IN
46342-6638
US

IV. Provider business mailing address

404 SANDALWOOD DR
VALPARAISO IN
46385-8118
US

V. Phone/Fax

Practice location:
  • Phone: 219-945-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28260493A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: