1346467008 NPI number — MR. ROBERT WAYNE KLEIN FNP-BC

Table of content: MR. ROBERT WAYNE KLEIN FNP-BC (NPI 1346467008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346467008 NPI number — MR. ROBERT WAYNE KLEIN FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEIN
Provider First Name:
ROBERT
Provider Middle Name:
WAYNE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346467008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3086
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGANTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28680-3086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-438-8577
Provider Business Mailing Address Fax Number:
828-438-8507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 AVERY AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-3102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-391-6384
Provider Business Practice Location Address Fax Number:
828-391-1972
Provider Enumeration Date:
04/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  2007001923-22 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7004910 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1346467008 . This is a "BC" identifier . This identifiers is of the category "OTHER".




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