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Individual

MRS. KIMBERLY SHAWN KLINK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2828 E DAVIS DR, TERRE HAUTE, IN 47802-9327
(812) 917-2169
Mailing address
2828 E DAVIS DR, TERRE HAUTE, IN 47802-9327
(812) 917-2169

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001418A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000360964
ANTHEM BLUE CROSS BLUE SH
IN
05
200508910
IN
Enumeration date
11/10/2005
Last updated
03/07/2012
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