Healthcare Provider Details

I. General information

NPI: 1831350941
Provider Name (Legal Business Name): JOSLYN KLINKEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STATE ROAD 54
TRINITY FL
34655-1808
US

IV. Provider business mailing address

413 DEVONIA ST
HARRIMAN TN
37748-2010
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4748
  • Fax: 865-882-9889
Mailing address:
  • Phone: 865-882-3211
  • Fax: 865-882-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number882273
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9458049
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: