Provider Demographics
NPI:1457326225
Name:KLIMA, MICHELLE (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KLIMA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6334 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3898
Mailing Address - Country:US
Mailing Address - Phone:410-531-2355
Mailing Address - Fax:410-531-7041
Practice Address - Street 1:6334 CEDAR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3898
Practice Address - Country:US
Practice Address - Phone:410-531-2355
Practice Address - Fax:410-531-7041
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107834363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP25604Medicare UPIN