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General NPI Number Information
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NPI Number | 1023886546
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Entity Type | Organization
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Legal Business Name | CLAUSSEN COLLABORATIVE MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 3165 STILLWATER DR
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City | PRESCOTT
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State | AZ
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Zip | 86305-7173
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Country | US
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Telephone | 928-277-0875
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 SUMMER VIEW DR
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City | PRESCOTT
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State | AZ
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Zip | 86301-8129
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Country | US
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Telephone | 928-499-0787
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SPENCER JAMES CLAUSSEN
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Credential | FNP, PMHNP
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Telephone | 928-499-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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