Provider Demographics
NPI:1497871313
Name:KLOPFENSTEIN, CONNIE LEE (BECKER) (APRN, CS)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:LEE (BECKER)
Last Name:KLOPFENSTEIN
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Gender:F
Credentials:APRN, CS
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Mailing Address - Street 1:1605 DUMBARTON LN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3602
Mailing Address - Country:US
Mailing Address - Phone:770-487-8384
Mailing Address - Fax:770-487-8384
Practice Address - Street 1:1501A KALAMAZOO DR
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-3919
Practice Address - Country:US
Practice Address - Phone:770-358-8280
Practice Address - Fax:770-229-3373
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GARN R070429364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN R070429OtherAPRN RN LICENSE NUMBER