Provider Demographics
NPI:1497740971
Name:KLEIN, MARTA L (PA)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:L
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7408
Mailing Address - Country:US
Mailing Address - Phone:785-825-7251
Mailing Address - Fax:785-825-6887
Practice Address - Street 1:651 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7408
Practice Address - Country:US
Practice Address - Phone:785-825-7251
Practice Address - Fax:785-825-6887
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00981363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS426767OtherBLUE CROSS BLUE SHIELD
KS461584OtherCHILDRENS MERCY FAMILY HP
KS426767OtherBLUE CROSS BLUE SHIELD
KS461584OtherCHILDRENS MERCY FAMILY HP