Kostich, Loryjean M

Kostich, Loryjean M is an individual health care provider with primary practice located at 700 S Park St , Madison WI 53715-1830. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Kostich, Loryjean M can be contacted via phone (608) 252-7458.

Contact Information

Primary practice address
700 S Park St Madison WI 53715-1830
Phone: (608) 252-7458
Fax: (608) 258-6772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 105203-030 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 105203-032 Wisconsin

Profile Details

NPI number 1669589107
LBN Legal business name Kostich, Loryjean M
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Dec 4th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669589107 NPPES
Wisconsin MEDICAID 1669589107

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