MEDICARE: MRS. NATALIE KLOSTRIECH FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	21613	CA

General Provider Information

NPI Number	:	1972958825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE KLOSTRIECH FNP

Provider Business Mailing Address
First Line	:	853 W ASTER ST
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-2226
Country	:	US
Telephone Number	:	909-313-9864
Fax Number	:

Provider Business Practice Location Address
First Line	:	15342 EL PRADO RD
Second Line	:	UNIT 200
City	:	CHINO
State	:	CA
Zip	:	91710-7659
Country	:	US
Telephone Number	:	888-591-0709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	04/28/2016

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