Provider Demographics
NPI:1598360851
Name:KLEIN, KRISTEN ROSE (APN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ROSE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CROW HILL LN
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8401
Mailing Address - Country:US
Mailing Address - Phone:732-977-9917
Mailing Address - Fax:
Practice Address - Street 1:106 APPLE ST STE 100C
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-2669
Practice Address - Country:US
Practice Address - Phone:732-747-5022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ010176200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily