Provider Demographics
NPI:1619930377
Name:KLIMAS, JENNIFER B (DNP, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:B
Last Name:KLIMAS
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:B
Other - Last Name:RYALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:6 S POINSETT HWY
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1822
Mailing Address - Country:US
Mailing Address - Phone:864-834-7834
Mailing Address - Fax:864-834-7477
Practice Address - Street 1:6 S POINSETT HWY
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1822
Practice Address - Country:US
Practice Address - Phone:864-834-7834
Practice Address - Fax:864-834-7477
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1672363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0618Medicaid
SCNP0618Medicaid
SC4695Medicare PIN
SCP60824Medicare UPIN