Provider Demographics
NPI:1750692133
Name:KLINE, ROXANNE LYNN (CERTIFIED NURSES AST)
Entity type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:F
Credentials:CERTIFIED NURSES AST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 CENTRAL AVE
Mailing Address - Street 2:B-206
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-1200
Mailing Address - Country:US
Mailing Address - Phone:708-629-0564
Mailing Address - Fax:
Practice Address - Street 1:14700 CENTRAL AVE
Practice Address - Street 2:B-206
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-1200
Practice Address - Country:US
Practice Address - Phone:708-629-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide