Individual
MS. MADISON LEIGH KLAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1690 W LANE AVE UNIT 401, COLUMBUS, OH 43221-2588
(405) 820-0029
Mailing address
1690 W LANE AVE UNIT 401, COLUMBUS, OH 43221-2588
(405) 820-0029
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
1059920
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2022
Last updated
10/06/2022
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