Provider Demographics
NPI:1427683572
Name:KLEESS, ANNABEL (MD)
Entity type:Individual
Prefix:
First Name:ANNABEL
Middle Name:
Last Name:KLEESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS EMORY S LAND
Mailing Address - Street 2:100104 BOX 200
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96667
Mailing Address - Country:US
Mailing Address - Phone:671-343-1124
Mailing Address - Fax:
Practice Address - Street 1:POLARIS POINT
Practice Address - Street 2:
Practice Address - City:AGANA
Practice Address - State:GU
Practice Address - Zip Code:96667
Practice Address - Country:US
Practice Address - Phone:671-343-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101272718171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider