Provider Demographics
NPI:1992494322
Name:KLEIN, GABRIELLE YVONNE (LPN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:YVONNE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-227 WAIKALANI DR APT A1205
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3543
Mailing Address - Country:US
Mailing Address - Phone:808-425-2658
Mailing Address - Fax:
Practice Address - Street 1:56-119 PUALALEA ST
Practice Address - Street 2:
Practice Address - City:KAHUKU
Practice Address - State:HI
Practice Address - Zip Code:96731-2052
Practice Address - Country:US
Practice Address - Phone:808-293-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILPN-20452164W00000X
AZ242720164W00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach