Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 32950 | AZ |
Y | 208000000X | Pediatrician | 68641 | WI |
NPI | 1376625327 |
---|---|
Provider Name | Dr. Julie A Klein |
First Address | Burlington, WI 53105-1828 |
Second Address | Burlington, WI 53105-1828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 16/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
877970 | AHCCCS (01) | AZ |
877970-01 | (05) | AZ |
I14521 | (02) |