Provider Demographics
NPI:1639283989
Name:KLINE, ELIZABETH EVINS (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EVINS
Last Name:KLINE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-269-5211
Mailing Address - Fax:814-269-5233
Practice Address - Street 1:1450 SCALP AVE
Practice Address - Street 2:STE 2100
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3321
Practice Address - Country:US
Practice Address - Phone:814-269-5211
Practice Address - Fax:814-269-5233
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PATP002259B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily