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General NPI Number Information
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NPI Number | 1174541700
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Entity Type | Individual
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Provider Name | MR. JIM CLASEN
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 310 COUNTY ROAD 14
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City | DEL NORTE
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State | CO
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Zip | 81132-8758
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Country | US
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Telephone | 719-657-2510
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Fax | 719-657-4106
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Provider Business Mailing Address
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Address Line | 4468 COUNTY ROAD 104 S
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City | ALAMOSA
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State | CO
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Zip | 81101-9752
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Country | US
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Telephone | 620-694-4067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C-APN.0103730-C-CRNA
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License Number State | CO
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