Provider Demographics
NPI:1841674470
Name:CLINE, JEFFREY CLARK (NBC-HIS)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CLARK
Last Name:CLINE
Suffix:
Gender:M
Credentials:NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 13TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3747
Mailing Address - Country:US
Mailing Address - Phone:828-328-5800
Mailing Address - Fax:704-749-8553
Practice Address - Street 1:37 13TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3747
Practice Address - Country:US
Practice Address - Phone:828-328-5800
Practice Address - Fax:704-749-8553
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1125237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC200590625Medicaid