1457360513 NPI number — MRS. KRISTIN NOELLE KLEMANN R.D.

Table of content: MRS. KRISTIN NOELLE KLEMANN R.D. (NPI 1457360513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457360513 NPI number — MRS. KRISTIN NOELLE KLEMANN R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEMANN
Provider First Name:
KRISTIN
Provider Middle Name:
NOELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

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:
1457360513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
551 BATTEN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32507-8662
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-492-9342
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NAVAL HOSPITAL PENSACOLA 6000 WEST HIGHWAY 98
Provider Second Line Business Practice Location Address:
MEDICAL NUTRITION THERAPY DEPT
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-492-9342
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2006

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: 132700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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