Provider Demographics
NPI:1831072685
Name:CLOSTER, CARRIE LYNN (RN,BSN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:CLOSTER
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 W ANCHOR DR
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5273
Mailing Address - Country:US
Mailing Address - Phone:605-232-2800
Mailing Address - Fax:612-725-1097
Practice Address - Street 1:380 W ANCHOR DR
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5273
Practice Address - Country:US
Practice Address - Phone:605-232-2800
Practice Address - Fax:612-725-1097
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59043163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty