Provider Demographics
NPI:1437551306
Name:KLINE, JANESSEY NICHOLE (RN, MSN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JANESSEY
Middle Name:NICHOLE
Last Name:KLINE
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 E 7TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-2536
Mailing Address - Country:US
Mailing Address - Phone:260-925-0666
Mailing Address - Fax:260-925-0669
Practice Address - Street 1:1306 E 7TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2536
Practice Address - Country:US
Practice Address - Phone:260-925-0666
Practice Address - Fax:260-925-0669
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28182481A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily