Kosko, Mamie M
Kosko, Mamie M is an individual health care provider with primary practice located at 100 Wilburn Way , Starkville MS 39759-3692. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kosko, Mamie M can be contacted via phone (662) 320-4008.Contact Information
Primary practice address
100 Wilburn Way
Starkville MS 39759-3692
Phone: (662) 320-4008
Fax: (662) 320-2450
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R872464 | Mississippi |
Profile Details
| NPI number | 1104107036 |
|---|---|
| LBN Legal business name | Kosko, Mamie M |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2011 |
| Last updated | Feb 24th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104107036 | NPPES |
| Mississippi | MEDICAID | 05676593 |
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