Healthcare Provider Details

I. General information

NPI: 1346458890
Provider Name (Legal Business Name): CATHERINE T COSCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE TONN-COSCIA NP

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SENATE BLVD ROOM AG001
INDIANAPOLIS IN
46202-1239
US

IV. Provider business mailing address

250 N SHADELAND AVE STE 200
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 314-796-2388
  • Fax: 317-962-8652
Mailing address:
  • Phone: 317-963-2720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71000248A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: