Provider Demographics
NPI:1083617500
Name:KLINKE, JANICE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
Last Name:KLINKE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 PROSPECT CIR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1645
Mailing Address - Country:US
Mailing Address - Phone:717-227-0429
Mailing Address - Fax:
Practice Address - Street 1:214 PROSPECT CIR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1645
Practice Address - Country:US
Practice Address - Phone:717-227-0429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN148547L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA008691Medicare PIN
S55001Medicare UPIN