Provider Demographics
NPI:1841007119
Name:KLINE, DAKODA
Entity type:Individual
Prefix:
First Name:DAKODA
Middle Name:
Last Name:KLINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 S YORK ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IN
Mailing Address - Zip Code:46701-1152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:709 S YORK ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:IN
Practice Address - Zip Code:46701-1152
Practice Address - Country:US
Practice Address - Phone:260-564-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker