Provider Demographics
NPI:1164962247
Name:KLAESS, CYNTHIA (MSN, APRN, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:KLAESS
Suffix:
Gender:F
Credentials:MSN, APRN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 PUNGO TRL
Mailing Address - Street 2:
Mailing Address - City:PINETOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27865-9703
Mailing Address - Country:US
Mailing Address - Phone:919-210-9015
Mailing Address - Fax:
Practice Address - Street 1:65 PUNGO TRL
Practice Address - Street 2:
Practice Address - City:PINETOWN
Practice Address - State:NC
Practice Address - Zip Code:27865-9703
Practice Address - Country:US
Practice Address - Phone:919-210-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC089850364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health