Provider Demographics
NPI:1760446132
Name:KLINE, DAVID LYNN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN233532L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001378185OtherHIGHMARK
PA430079640OtherRR MEDICARE
PA50055784OtherCAPITAL BLUE CROSS
PA50055784OtherKEYSTONE HEALTH PLAN CENTRAL
PA7811772OtherAETNA-NON HMO
PA93842OtherGEISINGER
PA1148072OtherAETNA-HMO
PA2070078000OtherINDEPENDENCE BLUE CROSS
PA020887Medicare ID - Type Unspecified