Healthcare Provider Details

I. General information

NPI: 1215290101
Provider Name (Legal Business Name): LIVIA LEORA KLEIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2012
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 SW WATERSTONE DR
GRANTS PASS OR
97527-6437
US

IV. Provider business mailing address

1734 SW WATERSTONE DR
GRANTS PASS OR
97527-6437
US

V. Phone/Fax

Practice location:
  • Phone: 813-404-9832
  • Fax: 541-226-2328
Mailing address:
  • Phone: 813-404-9832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201806310
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: