Jeremy Klein

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP61176673 Issued in WA

Practice address

590 Mitchell Blvd BLDG 37547TH
Laughlin Afb, TX 78843-5242

Phone

(830) 298-6386

NPI assigned

Feb 9, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1043842909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MITCHELL BLVD BLDG 37547TH",
            "city": "LAUGHLIN AFB",
            "state": "TX",
            "postal_code": "788435242",
            "telephone_number": "830-298-6386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-539-9582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "559 MDS",
            "address_2": "221 3rd St W Bldg 1040",
            "address_purpose": "LOCATION",
            "city": "Jbsa Randolph",
            "state": "TX",
            "postal_code": "781504800",
            "country_code": "US",
            "telephone_number": "210-652-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-09",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WA",
            "license": "RN60866146",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP61176673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dow, PSYD
• Sharon Ellison, LCSW
• Jennifer Hofmann, RD
• Felix Islas, DPT
• Micaela A Jett, MD
• Alecia Lapp, PSY.D.
• Paul Lickteig, DPT
• Michelle Massie, O.D.
• Jeffrey Myers, DO
• Cambria Pinckney, O.D.

• All providers in Laughlin Afb, TX
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.