Healthcare Provider Details

I. General information

NPI: 1760493720
Provider Name (Legal Business Name): ELIZABETH L CLAASSEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MEDICAL CENTER DR
NEWTON KS
67114-8778
US

IV. Provider business mailing address

720 MEDICAL CENTER DR
NEWTON KS
67114-8778
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-5155
  • Fax: 316-284-5110
Mailing address:
  • Phone: 316-283-6103
  • Fax: 316-283-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number00719
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: