MEDICARE: POLLY ANNA KLEMENT NP

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	363L00000X	Nurse Practitioner	716516	TX

General Provider Information

NPI Number	:	1437440039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POLLY ANNA KLEMENT NP

Provider Business Mailing Address
First Line	:	PO BOX 647
Second Line	:
City	:	MUENSTER
State	:	TX
Zip	:	76252-0647
Country	:	US
Telephone Number	:	940-759-2502
Fax Number	:	940-759-3608

Provider Business Practice Location Address
First Line	:	801 N GRAND AVE
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-3573
Country	:	US
Telephone Number	:	940-612-8560
Fax Number	:	940-665-0209

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

Provider Enumeration Date	:	04/29/2011
Last Update Date	:	05/15/2014

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