Provider Demographics
NPI:1811141799
Name:KLEE, MICHELE LYNN (LPN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:KLEE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 REINER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-6341
Mailing Address - Country:US
Mailing Address - Phone:608-770-9996
Mailing Address - Fax:
Practice Address - Street 1:5007 REINER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-6341
Practice Address - Country:US
Practice Address - Phone:608-770-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI309914-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35066300Medicaid