Healthcare Provider Details

I. General information

NPI: 1275902785
Provider Name (Legal Business Name): MICHELLE KLEIN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S GREENE ST DIVISION OF TRANSPLANTATION (2ND FLOOR/LIVER TRANSPLANT
BALTIMORE MD
21201-1504
US

IV. Provider business mailing address

901 WINDWHISPER LN
ANNAPOLIS MD
21403-3486
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5408
  • Fax:
Mailing address:
  • Phone: 301-412-9059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR157851
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR1577851
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: