Individual
MRS. KIRBY L KLOSTERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2 COTTONWOOD RD, GLEN CARBON, IL 62034-2782
(618) 288-1772
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277000540
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900710
GROUP MEDICARE NUMBER
IL
Enumeration date
09/10/2007
Last updated
01/06/2022
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