MEDICARE: MS. JEANNE MARIE KLEIN MSN, RN, NP-C

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	363LF0000X	Family Nurse Practitioner	COA.14995	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H257770	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396186094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANNE MARIE KLEIN MSN, RN, NP-C

Provider Business Mailing Address
First Line	:	7755 PARAGON RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4055
Country	:	US
Telephone Number	:	937-683-6267
Fax Number	:

Provider Business Practice Location Address
First Line	:	7755 PARAGON RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4055
Country	:	US
Telephone Number	:	937-683-6267
Fax Number	:

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

Provider Enumeration Date	:	07/10/2013
Last Update Date	:	01/06/2017

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