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NPI Code Detail

MEDICARE: PAM J KLINT N.P

MEDICARE: PAM J KLINT N.P
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner4704153223MI

General Provider Information

NPI Number : 1033509286
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAM J KLINT N.P
Provider Business Mailing Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Provider Business Practice Location Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2015
Last Update Date : 01/27/2015

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Directions to “ PAM J KLINT N.P” Practice Location

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