MRS. KIRBY KOONCE KLOSTERMANN (NPI# 1285829572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285829572 |
| Entity Type | Individual |
| Full Name | MRS. KIRBY KOONCE KLOSTERMANN |
| Credential | FNP |
| Practice Address |
2 Cottonwood Rd Glen Carbon IL 62034-2782 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
| Practice Telephone | 6182881772 |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2020-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 277000540 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 209006670 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 209.006670 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | GROUP MEDICARE NUMBER | 900710 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 33 Bronze Pointe, Suite 150, Belleville, IL 622268305 | 6182338000 | 6182338070 |
| Street Address |
2 COTTONWOOD RD |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034-2782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609881838 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2006-07-29 |
| 1851896146 | Ssm Medical Group, Inc. | Clinic/Center | 2 Cottonwood Rd, Glen Carbon, IL 62034 | 2018-03-28 |
| 1306365556 | Leah Marie Trower | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2017-09-19 |
| 1215481924 | Samantha Alexandria Collins | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2016-08-10 |
| 1083096895 | Ranita Keller | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2015-06-29 |
| 1396032454 | Mary Margaret Worster | Pharmacist | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2011-07-08 |
| 1417244740 | Heidi Marie Trackwell | Pharmacist | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2011-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486802 | Sarah Elizabeth Halsey | Nurse Practitioner | 4215 S State Route 159 Ste 22nd, Glen Carbon, IL 62034-3267 | 2020-08-03 |
| 1386005635 | Randi M Hummel | Nurse Practitioner | 7124 Augusta Dr, Glen Carbon, IL 62034-3091 | 2016-03-15 |
| 1306365556 | Leah Marie Trower | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2017-09-19 |
| 1215481924 | Samantha Alexandria Collins | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2016-08-10 |
| 1083096895 | Ranita Keller | Nurse Practitioner | 2 Cottonwood Rd, Glen Carbon, IL 62034-2782 | 2015-06-29 |
| 1083852974 | Uptown Emergency Physicians, LLP | Nurse Practitioner | 17 Ginger Creek Mdws, Glen Carbon, IL 62034-3508 | 2009-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578523 | Kaitlin Lawson Kalnitz | Nurse Practitioner | 745 Mcclintock Dr Ste 360, Burr Ridge, IL 60527-0875 | 2020-11-06 |
| 1841890290 | Maria Malanych | Nurse Practitioner | 5731 Rosinweed Ln, Naperville, IL 60564-1635 | 2020-10-27 |
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1295334811 | Mary Farley | Nurse Practitioner | 7308 Northwood Dr, Wonder Lake, IL 60097-8606 | 2020-10-24 |
| 1164021168 | Stephanie Schuster | Nurse Practitioner | 2665 Prairieview Ln N, Aurora, IL 60502-6343 | 2020-10-21 |
| 1316546641 | Vanessa K Bajaj | Nurse Practitioner | 1123 N Claremont Dr, Palatine, IL 60074-4002 | 2020-10-19 |
| 1003414442 | Gachugu Medical Clinic | Nurse Practitioner | 1 E Ferguson Ave, Wood River, IL 62095-1903 | 2020-10-16 |
| 1477151272 | Yolanda K Bradford | Nurse Practitioner | 2700 S California Ave, Chicago, IL 60608-5108 | 2020-10-14 |
| 1265030019 | Andrea Mclean | Nurse Practitioner | 2500 W Reynolds St # 205, Pontiac, IL 61764-9774 | 2020-10-14 |
| 1558968628 | Timothy Nenoff | Nurse Practitioner | 24722 Lincolnway St, Plainfield, IL 60544-2412 | 2020-10-02 |
| Find all providers with the same taxonomy | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.