Provider Demographics
NPI:1730666264
Name:KLINE, SAMANTHA (PA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:KLINE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:7700 W ASPERA BLVD APT 2052
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7926
Mailing Address - Country:US
Mailing Address - Phone:509-209-6928
Mailing Address - Fax:
Practice Address - Street 1:10401 W THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3004
Practice Address - Country:US
Practice Address - Phone:623-832-5772
Practice Address - Fax:623-832-7520
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant