Provider Demographics
NPI:1518188614
Name:KLINE, MISTY LYNN (RN, CCRN, MSN, ACNP)
Entity Type:Individual
Prefix:MS
First Name:MISTY
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:F
Credentials:RN, CCRN, MSN, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WEMPE DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3705
Mailing Address - Country:US
Mailing Address - Phone:301-876-0236
Mailing Address - Fax:304-579-2673
Practice Address - Street 1:510 BUTLER AVE STE 413-B
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-9990
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:304-579-2673
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN967986363LA2100X
VA0024167227363LA2100X
CA715923363LA2100X
MDR133350363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care