Healthcare Provider Details

I. General information

NPI: 1710816244
Provider Name (Legal Business Name): GWEN KLINKNER DNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVE # MC6736
MADISON WI
53792-0001
US

IV. Provider business mailing address

600 HIGHLAND AVE # MC6736
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-8225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number127008-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: