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NPI Code Detail

MEDICARE: CRYSTAL KLINE CNP

MEDICARE: CRYSTAL KLINE CNP
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.022452OH
2363LP2300XPrimary Care Nurse Practitioner022452OH
3363L00000XNurse PractitionerAPRN.CNP.022452OH

General Provider Information

NPI Number : 1295227437
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL KLINE CNP
Provider Business Mailing Address
First Line : 2200 JEFFERSON AVE FL 5
Second Line :
City : TOLEDO
State : OH
Zip : 43604-7102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 442 W HIGH ST STE 3
Second Line :
City : BRYAN
State : OH
Zip : 43506-1681
Country : US
Telephone Number : 419-636-4517
Fax Number : 419-633-7256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2018
Last Update Date : 02/09/2026

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Directions to “ CRYSTAL KLINE CNP” Practice Location

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