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Individual
KELLY KLINE
Active
Individual
KELLY KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343335
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000542232001
BLUE CROSS
NY
05
—
05251381
—
NY
Enumeration date
07/17/2018
Last updated
04/29/2022
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