Provider Demographics
NPI:1497236079
Name:KLEIN, MARIA DEPRANG (FNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEPRANG
Last Name:KLEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 VILLA SERENA CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1050
Mailing Address - Country:US
Mailing Address - Phone:915-799-1613
Mailing Address - Fax:
Practice Address - Street 1:1300 MURCHISON DR STE 310B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4853
Practice Address - Country:US
Practice Address - Phone:915-706-2500
Practice Address - Fax:915-225-0109
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF07182129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily