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General NPI Number Information
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NPI Number | 1376835991
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Entity Type | Individual
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Provider Name | PEGGY WILDS KLEIN ARNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/15/2011
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 2572 W STATE ROAD 426 SUITE 3056
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City | OVIEDO
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State | FL
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Zip | 32765-8389
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Country | US
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Telephone | 407-706-6580
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Fax | 407-706-6586
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Provider Business Mailing Address
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Address Line | 4673 ANSON LN
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City | ORLANDO
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State | FL
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Zip | 32814-6074
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Country | US
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Telephone | 407-687-4302
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9171124
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN9171124
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License Number State | FL
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