Healthcare Provider Details

I. General information

NPI: 1235949165
Provider Name (Legal Business Name): AMBER KLEMANN RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MATTEAWAN RD
BEACON NY
12508-1571
US

IV. Provider business mailing address

10 EDUCATION DR # 1
BEACON NY
12508-4066
US

V. Phone/Fax

Practice location:
  • Phone: 845-838-6900
  • Fax:
Mailing address:
  • Phone: 845-838-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number714798-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number714798-01
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number714798-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: