MEDICARE: MS. AMY KLINE F.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
1	363LF0000X	Family Nurse Practitioner	R110820-2	MN

General Provider Information

NPI Number	:	1528042207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY KLINE F.N.P.

Provider Business Mailing Address
First Line	:	920 E 28TH ST
Second Line	:	SUITE #300
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1139
Country	:	US
Telephone Number	:	612-863-3963
Fax Number	:	612-863-1681

Provider Business Practice Location Address
First Line	:	920 E 28TH ST
Second Line	:	SUITE #300
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1139
Country	:	US
Telephone Number	:	612-863-3963
Fax Number	:	612-863-1681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	10/31/2011

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