Provider Demographics
NPI:1457062762
Name:KLINE, MADELINE LOUISE
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:LOUISE
Last Name:KLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4599 S FIRESTONE RD
Mailing Address - Street 2:
Mailing Address - City:SHREVE
Mailing Address - State:OH
Mailing Address - Zip Code:44676-9206
Mailing Address - Country:US
Mailing Address - Phone:330-464-9674
Mailing Address - Fax:
Practice Address - Street 1:2570 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9017
Practice Address - Country:US
Practice Address - Phone:330-439-3049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator