Provider Demographics
NPI:1346738986
Name:KLJAIC, DRAGANA VUJIC (AGACNP)
Entity Type:Individual
Prefix:MRS
First Name:DRAGANA
Middle Name:VUJIC
Last Name:KLJAIC
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 WINDSOR PL STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1866
Mailing Address - Country:US
Mailing Address - Phone:682-207-1700
Mailing Address - Fax:682-250-5246
Practice Address - Street 1:1902 WINDSOR PL STE 102
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1866
Practice Address - Country:US
Practice Address - Phone:682-207-1700
Practice Address - Fax:682-250-5246
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137105363L00000X, 363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX387362201Medicaid