Provider Demographics
NPI:1811712102
Name:KLOSTER, NIOMI IZABELLA (LPN)
Entity type:Individual
Prefix:
First Name:NIOMI
Middle Name:IZABELLA
Last Name:KLOSTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4438
Mailing Address - Country:US
Mailing Address - Phone:405-888-7535
Mailing Address - Fax:
Practice Address - Street 1:212 BARBARA DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4438
Practice Address - Country:US
Practice Address - Phone:405-888-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219893164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse