MEDICARE: AMY KLING

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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1740004324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY KLING

Provider Business Mailing Address
First Line	:	3622 N 38TH ST UNIT 7
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5851
Country	:	US
Telephone Number	:	281-744-2798
Fax Number	:

Provider Business Practice Location Address
First Line	:	3622 N 38TH ST UNIT 7
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5851
Country	:	US
Telephone Number	:	281-744-2798
Fax Number	:

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

Provider Enumeration Date	:	11/11/2024
Last Update Date	:	11/11/2024

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Directions to “ AMY KLING ” Practice Location

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