Provider Demographics
NPI:1841918596
Name:KLEIN, ANGELA J (BSN, CNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:F
Credentials:BSN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 CAMPUS DR STE 10
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-8812
Mailing Address - Country:US
Mailing Address - Phone:763-398-4400
Mailing Address - Fax:651-342-1428
Practice Address - Street 1:2800 CAMPUS DR STE 10
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-8812
Practice Address - Country:US
Practice Address - Phone:763-398-2215
Practice Address - Fax:651-342-1428
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9419363L00000X, 363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care