Provider Demographics
NPI:1356390553
Name:KLOPFER, TERESA L (CRNA)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:KLOPFER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2432
Mailing Address - Country:US
Mailing Address - Phone:325-670-2277
Mailing Address - Fax:325-670-8292
Practice Address - Street 1:1900 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2432
Practice Address - Country:US
Practice Address - Phone:325-670-2277
Practice Address - Fax:325-670-8292
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-242748367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH730565OtherBUCKEYE COMMUNITY HLTH PL
OH2023250Medicaid
OH120772OtherKAISER PERMANENTE INDV #
OH000000125779OtherANTHEM BCBS INDV NUMBER
OH100153OtherEMPLOYER KAISER GROUP #
OH34-0891295OtherEMPLOYER FEDERAL TAX ID #
OH2080224OtherUNITED HEALTHCARE GROUP #
OH7091249Medicaid
OHKL8221002Medicare ID - Type UnspecifiedMEDICARE INDV NUMBER
OH000000125779OtherANTHEM BCBS INDV NUMBER