Provider Demographics
NPI:1710389937
Name:KLINE, DANA MICHAEL (RN, WHNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MICHAEL
Last Name:KLINE
Suffix:
Gender:X
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 PINEHURST AVE
Practice Address - Street 2:APT #A3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6404
Practice Address - Country:US
Practice Address - Phone:917-226-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691239163W00000X
NYF421471363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse