Healthcare Provider Details

I. General information

NPI: 1316907678
Provider Name (Legal Business Name): DONNA MAY KLAHN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 PAINTED POST DR
MADISON WI
53716-1557
US

IV. Provider business mailing address

46 CHURCH ST P.O.BOX 622
MONTELLO WI
53949-9702
US

V. Phone/Fax

Practice location:
  • Phone: 608-221-2368
  • Fax:
Mailing address:
  • Phone: 608-297-7599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number83420-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: