Provider Demographics
NPI:1760993109
Name:KLEIN, TRAVIS ROBERT (CNP)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:ROBERT
Last Name:KLEIN
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 COMPASS DR STE 377
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8723
Mailing Address - Country:US
Mailing Address - Phone:970-241-2212
Mailing Address - Fax:970-257-2401
Practice Address - Street 1:2754 COMPASS DR STE 377
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-241-2212
Practice Address - Fax:970-257-2401
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011798363LA2100X, 363LG0600X
OHAPRN.CNP.022386363LG0600X
COAPN.0994461-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care