1376414912 NPI number — MEGAN DEANNE TADLOCK KLOSTERMANN ARNP

Table of content: MEGAN DEANNE TADLOCK KLOSTERMANN ARNP (NPI 1376414912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376414912 NPI number — MEGAN DEANNE TADLOCK KLOSTERMANN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLOSTERMANN
Provider First Name:
MEGAN
Provider Middle Name:
DEANNE TADLOCK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TADLOCK
Provider Other First Name:
MEGAN
Provider Other Middle Name:
DEANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376414912
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 10TH ST SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52403-2414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 10TH ST SE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52403-2424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-363-8171
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  A187017 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com