Provider Demographics
NPI:1023743531
Name:KLINE, KELLY JO (CNM)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:JO
Last Name:KLINE
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:152 ZEMAN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4130
Mailing Address - Country:US
Mailing Address - Phone:814-471-2277
Mailing Address - Fax:
Practice Address - Street 1:152 ZEMAN DR STE 102
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4130
Practice Address - Country:US
Practice Address - Phone:814-471-2271
Practice Address - Fax:814-471-2216
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2023-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMW010689367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife