Provider Demographics
NPI:1437232766
Name:KLEIN, MEGAN K (APRN, MS, LS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:KLEIN
Suffix:
Gender:F
Credentials:APRN, MS, LS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 CASE ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2222
Mailing Address - Country:US
Mailing Address - Phone:860-823-1399
Mailing Address - Fax:860-823-1170
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:SUITE 314
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-823-1399
Practice Address - Fax:860-823-1170
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT22922363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD80821Medicare UPIN