Provider Demographics
NPI:1568240489
Name:KLEIN, NICOLE J (PHD, RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 199TH STREET CT. E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387
Mailing Address - Country:US
Mailing Address - Phone:253-761-6406
Mailing Address - Fax:
Practice Address - Street 1:1705 199TH STREET CT. E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387
Practice Address - Country:US
Practice Address - Phone:253-761-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00158491163W00000X, 163WC0400X, 163WC1400X, 163WC1500X, 163WC1600X, 163WG0000X, 163WP0807X, 163WN1003X, 163WP0200X, 163WP2201X, 163WS0200X, 163WP0809X, 163WW0101X
WIRN00158491163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory