Klett-Kimble, Bethany Marie
Klett-Kimble, Bethany Marie is an individual health care provider with primary practice located at 835 S Van Buren St , Green Bay WI 54301-3526. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is her primary health care specialty. Klett-Kimble, Bethany Marie can be contacted via phone (920) 433-0111.Contact Information
Primary practice address
835 S Van Buren St
Green Bay WI 54301-3526
Phone: (920) 433-0111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 75204 | Wisconsin |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 75204 | Wisconsin |
Profile Details
| NPI number | 1679068381 |
|---|---|
| LBN Legal business name | Klett-Kimble, Bethany Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2018 |
| Last updated | Jul 10th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679068381 | NPPES |
| Wisconsin | MEDICAID | 1679068381 |
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