Doctor Name: | MS. NANCY NEIBERG KOSANOVICH |
NPI Number: | 1497809255 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 9600229 |
Business Practice Address: | 2 Juniper Trail Kitty Hawk, NC - 279493732 |
Business Phone Number: | 2524419941 |
Business Fax Number: | 2524419943 |
Mailing Address: | 109 W Craig End, NAGS HEAD |
State: | NC |
Postal Code: | 279599530 |
Phone Number: | 2524498449 |
Fax Number: | |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 9600229 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |