Doctor Name: | MISS KATHLEEN M. KLOECKNER |
NPI Number: | 1336392711 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP-BC |
License Number: | 695897 |
Business Practice Address: | 16811 Ranch Road 12 Wimberley, TX - 786766070 |
Business Phone Number: | 5126183063 |
Business Fax Number: | 5128478746 |
Mailing Address: | 16811 Ranch Road 12, WIMBERLEY |
State: | TX |
Postal Code: | 786766070 |
Phone Number: | 5126183063 |
Fax Number: | 5128478746 |
NPI Enumeration Date: | 10/29/2008 |
NPI Last Update Date: | 12/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 695897 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |