Active NPI
Michelle Pack Klein, RN
- Registered Nurse
- Nacogdoches, TX
National Provider Identifier
1770152928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 595490
- Practice address
- 5707 North St
Nacogdoches, TX 75965-1325 - Phone
- (936) 468-7700
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 595490 | TX | Primary |
Addresses
Primary practice location
5707 North St
Nacogdoches, TX 75965-1325
Mailing address
PO Box 630641
Nacogdoches, TX 75963-0641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 595490 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1770152928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 630641",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759630641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5707 NORTH ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759651325",
"telephone_number": "936-468-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "MICHELLE",
"middle_name": "PACK",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "595490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.