Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1879962 | FL |
NPI | 1184827701 |
---|---|
Provider Name | Mrs. Lynn Kliem |
First Address | Satellite Beach, FL 32937-3942 |
Second Address | Plant City, FL 33563-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2007 |
Last Update Date | 09/07/2007 |