Healthcare Provider Details

I. General information

NPI: 1992304372
Provider Name (Legal Business Name): CATHERINE KOSKEI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MAIDEN CHOICE LN STE C
CATONSVILLE MD
21228-5940
US

IV. Provider business mailing address

1232 RACE ROAD STE 403
ROSEDALE MD
21237-2370
US

V. Phone/Fax

Practice location:
  • Phone: 443-334-5732
  • Fax:
Mailing address:
  • Phone: 443-868-7101
  • Fax: 443-732-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR213137
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: