Provider Demographics
NPI:1679576755
Name:KLAPPHOLZ, DAVID L (CRNA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:KLAPPHOLZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4454 N DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-5286
Mailing Address - Country:US
Mailing Address - Phone:702-839-1203
Mailing Address - Fax:702-839-1301
Practice Address - Street 1:4454 N DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-5286
Practice Address - Country:US
Practice Address - Phone:702-839-1203
Practice Address - Fax:702-839-1301
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15264200367500000X
SC4047367500000X
TX637070367500000X
TN000010225367500000X
NV868614367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00663775OtherRAILROAD MEDICARE
4162600OtherBCBS
TNP00663775OtherRAILROAD MEDICARE
SCQ354989477Medicare PIN