Provider Demographics
NPI:1972347573
Name:KLEINWOLTERINK, DEB (DNP)
Entity type:Individual
Prefix:
First Name:DEB
Middle Name:
Last Name:KLEINWOLTERINK
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 400TH ST
Mailing Address - Street 2:
Mailing Address - City:HOSPERS
Mailing Address - State:IA
Mailing Address - Zip Code:51238-8007
Mailing Address - Country:US
Mailing Address - Phone:712-441-3609
Mailing Address - Fax:
Practice Address - Street 1:700 7TH ST NE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-1671
Practice Address - Country:US
Practice Address - Phone:712-722-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA091034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse