Provider Demographics
NPI:1588801120
Name:KLOSTERMAN, KRISTINA ANNETTE (CRNP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANNETTE
Last Name:KLOSTERMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ANNETTE
Other - Last Name:RONNEBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30575 BAINBRIDGE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2275
Mailing Address - Country:US
Mailing Address - Phone:440-368-6868
Mailing Address - Fax:440-368-6866
Practice Address - Street 1:6001 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:513-281-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-10225363L00000X
OHAPRN.CNP.10225363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner