Doctor Name: | MRS. JENESSA D KLEOPFER |
NPI Number: | 1194061242 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | T-03507 |
Business Practice Address: | 1525 Madison St Suite 2 Fredonia, KS - 667361703 |
Business Phone Number: | 6203782068 |
Business Fax Number: | 6203782312 |
Mailing Address: | 1525 Madison St, Suite 2 FREDONIA |
State: | KS |
Postal Code: | 667361703 |
Phone Number: | 6203782068 |
Fax Number: | 6203782312 |
NPI Enumeration Date: | 12/18/2012 |
NPI Last Update Date: | 12/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | T-03507 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |