Provider Demographics
NPI:1730349135
Name:KLEMM, BARBARA ALMA (MS, RN, ANP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ALMA
Last Name:KLEMM
Suffix:
Gender:F
Credentials:MS, RN, ANP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ALMA
Other - Last Name:KLEMM-ELLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RN, ANP
Mailing Address - Street 1:125 PARKER HILL AVE
Mailing Address - Street 2:SUITE 502 FOGG
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2847
Mailing Address - Country:US
Mailing Address - Phone:617-754-6199
Mailing Address - Fax:617-754-6403
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:SUITE 502 FOGG
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:617-754-6199
Practice Address - Fax:617-754-6403
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188795363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health