MEDICARE: TINA MARIE KLEIN MSN, APRN, FNP-C

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	APRN11016092	FL

General Provider Information

NPI Number	:	1699438390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MARIE KLEIN MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	2891 TOWN TER
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-4352
Country	:	US
Telephone Number	:	941-585-8659
Fax Number	:

Provider Business Practice Location Address
First Line	:	2891 TOWN TER
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-4352
Country	:	US
Telephone Number	:	941-585-8659
Fax Number	:

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

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	10/19/2021

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