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Individual
AMANDA C KLEESE
Active
Individual
AMANDA C KLEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
C103068
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430876
—
IA
01
—
36094
WELLMARK BCBS
IA
Enumeration date
08/24/2005
Last updated
05/01/2014
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