| Doctor Name: | MRS. MARY CATHERINE KLOCKMANN |
| NPI Number: | 1003840174 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 402384RN |
| Business Practice Address: | 608 G Street Brawley Brawley, CA - 922272567 |
| Business Phone Number: | 7603511011 |
| Business Fax Number: | 7605450247 |
| Mailing Address: | 516 W Aten Rd, Imperial IMPERIAL |
| State: | CA |
| Postal Code: | 922519805 |
| Phone Number: | 7603557730 |
| Fax Number: | 7603557731 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 01/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 402384RN |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |