Provider Demographics
NPI:1154495935
Name:KLETSCHER, ERIN LEA (RN PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEA
Last Name:KLETSCHER
Suffix:
Gender:F
Credentials:RN PMHNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEA
Other - Last Name:KLETSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2010
Mailing Address - Country:US
Mailing Address - Phone:507-532-3236
Mailing Address - Fax:507-337-1118
Practice Address - Street 1:1212 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2010
Practice Address - Country:US
Practice Address - Phone:507-532-3236
Practice Address - Fax:507-337-1118
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 161460 2163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse