MEDICARE: MR. DAVID ALEXANDER KLEE RN, PCNS

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	364SP0807X	Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist	RN271366	MA
2	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	271366	MA

General Provider Information

NPI Number	:	1639382997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID ALEXANDER KLEE RN, PCNS

Provider Business Mailing Address
First Line	:	96 PLEASANT ST
Second Line	:
City	:	WAKEFIELD
State	:	MA
Zip	:	01880-1842
Country	:	US
Telephone Number	:	617-306-0692
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 GOULD ST
Second Line	:	SUITE 300
City	:	NEEDHAM
State	:	MA
Zip	:	02494-2313
Country	:	US
Telephone Number	:	781-559-4900
Fax Number	:

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	12/30/2015

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