Provider Demographics
NPI:1942292081
Name:KLEES-D'ALESSANDRO, HEIDI L (CRNA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:KLEES-D'ALESSANDRO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:L
Other - Last Name:KLEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:610-954-5810
Mailing Address - Fax:
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:610-954-5810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN 313359L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
753047838002OtherTRICARE
PADA1668080OtherHIGHMARK BLUE SHIELD
P00359231OtherRAILROAD MEDICARE
PA01846160Medicaid
20035314OtherAMERIHEALTH MERCY
PA01846160Medicaid
20035314OtherAMERIHEALTH MERCY
P21003Medicare UPIN