Provider Demographics
NPI:1154026490
Name:KLINE, NANCY (LVN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 TOCOLOMA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-2457
Mailing Address - Country:US
Mailing Address - Phone:415-840-6867
Mailing Address - Fax:
Practice Address - Street 1:2238 WESTBOROUGH BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5405
Practice Address - Country:US
Practice Address - Phone:650-873-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN168029164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse