Provider Demographics
NPI:1376613208
Name:KLEIN, HELEN ROSE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:ROSE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8061
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-3061
Mailing Address - Country:US
Mailing Address - Phone:907-247-8061
Mailing Address - Fax:
Practice Address - Street 1:3524 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5635
Practice Address - Country:US
Practice Address - Phone:907-225-9830
Practice Address - Fax:907-225-9840
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily