Provider Demographics
NPI:1497072391
Name:KLEINKE, DAWN D (RN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:D
Last Name:KLEINKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 N 116TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3001
Mailing Address - Country:US
Mailing Address - Phone:414-218-1025
Mailing Address - Fax:
Practice Address - Street 1:1663 N 116TH ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3001
Practice Address - Country:US
Practice Address - Phone:414-218-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16156030163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics