Provider Demographics
NPI:1831404946
Name:CLOSTIO, PAMELA SHARISE (CNM)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SHARISE
Last Name:CLOSTIO
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:1750 MCMANNAMY DRAW
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-257-5616
Mailing Address - Fax:406-260-4456
Practice Address - Street 1:1320 2ND AVE E
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5715
Practice Address - Country:US
Practice Address - Phone:406-257-5616
Practice Address - Fax:406-260-4456
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2013-04-22
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Provider Licenses
StateLicense IDTaxonomies
MT022709367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife