Provider Demographics
NPI:1770110231
Name:CLAUSEN, JENNIFER ANN (RD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W12727 LOCUST RD
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:WI
Mailing Address - Zip Code:54971-9703
Mailing Address - Country:US
Mailing Address - Phone:262-993-5718
Mailing Address - Fax:
Practice Address - Street 1:W12727 LOCUST RD
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-9703
Practice Address - Country:US
Practice Address - Phone:262-993-5718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered