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Individual

AUDREY CATHERINE KLECKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1005 COMMERCIAL LN STE 220, SUFFOLK, VA 23434-8149
(757) 668-2600
Mailing address
4012 BIRCHWOOD AVE, CHESAPEAKE, VA 23321-5302
(757) 928-5082

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024191406
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024191406
VIRGINIA BOARD OF NURSING LICENSE
VA
01
F08240389
AMERICAN ACADEMY OF NURSE PRACTITIONERS
Enumeration date
10/04/2024
Last updated
10/09/2024
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