Provider Demographics
NPI:1558674937
Name:KLIMENT, MIRANDA KAYE (APRN - FNP)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:KAYE
Last Name:KLIMENT
Suffix:
Gender:F
Credentials:APRN - FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4600 VALLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4882
Mailing Address - Country:US
Mailing Address - Phone:402-483-4571
Mailing Address - Fax:402-483-5079
Practice Address - Street 1:4600 VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4882
Practice Address - Country:US
Practice Address - Phone:402-483-4571
Practice Address - Fax:402-483-5079
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE111141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily