MEDICARE: MS. DAWN D KLUG PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1586933	WI
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	15869	WI

General Provider Information

NPI Number	:	1497072391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN D KLUG PMHNP-BC

Provider Business Mailing Address
First Line	:	4419 COUNTRY AIRE DR
Second Line	:
City	:	CEDARBURG
State	:	WI
Zip	:	53012-9603
Country	:	US
Telephone Number	:	262-388-5864
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 WALNUT ST
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53095-3331
Country	:	US
Telephone Number	:	414-418-4463
Fax Number	:	262-384-3747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2010
Last Update Date	:	03/11/2026

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