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NPI Code Detail

MEDICARE: MS. KIMBERLY KAY KOSATKA FNP-C

MEDICARE: MS. KIMBERLY KAY KOSATKA FNP-C
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
1363L00000XNurse Practitioner679390TX
2363L00000XNurse PractitionerAP114007TX

General Provider Information

NPI Number : 1134161862
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY KAY KOSATKA FNP-C
Provider Business Mailing Address
First Line : 6210 E HWY 290 STE 240
Second Line :
City : AUSTIN
State : TX
Zip : 78723-1144
Country : US
Telephone Number : 512-483-9596
Fax Number : 512-406-6216
Provider Business Practice Location Address
First Line : 2785 E 7TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-3907
Country : US
Telephone Number : 737-910-6700
Fax Number : 512-406-6296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 03/30/2023

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Directions to “ MS. KIMBERLY KAY KOSATKA FNP-C” Practice Location

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