Healthcare Provider Details

I. General information

NPI: 1659299568
Provider Name (Legal Business Name): BETH KLUDING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 OLD MCARTHUR RD
LOGAN OH
43138-8959
US

IV. Provider business mailing address

PO BOX 188
CHILLICOTHEE OH
45601-0188
US

V. Phone/Fax

Practice location:
  • Phone: 740-385-5116
  • Fax:
Mailing address:
  • Phone: 740-773-4366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.387753
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: