Provider Demographics
NPI:1528042207
Name:KLINE, AMY (FNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 E 28TH ST
Mailing Address - Street 2:SUITE #300
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1139
Mailing Address - Country:US
Mailing Address - Phone:612-863-3963
Mailing Address - Fax:612-863-1681
Practice Address - Street 1:920 E 28TH ST
Practice Address - Street 2:SUITE #300
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1139
Practice Address - Country:US
Practice Address - Phone:612-863-3963
Practice Address - Fax:612-863-1681
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR110820-2363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S95434Medicare UPIN