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General NPI Number Information
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NPI Number | 1043309180
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Entity Type | Individual
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Provider Name | MARTHA JANE KLINGER LPN
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5249 OLDE TOWNE RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8111
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Country | US
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Telephone | 757-259-3254
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Fax | 757-220-1953
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Provider Business Mailing Address
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Address Line | 3361 NEW CASTLE DR
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2475
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Country | US
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Telephone | 757-259-3268
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Fax | 757-220-1953
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0017001545
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License Number State | VA
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