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NPI Code Detail

MEDICARE: MRS. KATHERINE COSCA ROY FNP

MEDICARE: MRS. KATHERINE COSCA ROY FNP
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
1363LF0000XFamily Nurse Practitioner95013718CA

General Provider Information

NPI Number : 1558984120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE COSCA ROY FNP
Provider Business Mailing Address
First Line : 238 MARSALA
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-8308
Country : US
Telephone Number : 949-432-1744
Fax Number :
Provider Business Practice Location Address
First Line : 460 OLD NEWPORT BLVD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4211
Country : US
Telephone Number : 949-287-6880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2020
Last Update Date : 05/18/2020

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