Individual
JACQUI KLEEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 DEPOT ST, LA GRANDE, OR 97850-2616
(541) 963-3772
Mailing address
101 DEPOT ST, LA GRANDE, OR 97850-2616
(541) 963-3772
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201604512NP-PP
OR
Other
Enumeration date
03/06/2008
Last updated
08/26/2016
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