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Individual

JEREMY KLEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
590 MITCHELL BLVD BLDG 37547TH, LAUGHLIN AFB, TX 78843-5242
(830) 298-6386
Mailing address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
(210) 652-1951

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN60866146
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP61176673
WA

Other

Enumeration date
02/09/2020
Last updated
06/26/2025
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