Healthcare Provider Details

I. General information

NPI: 1205590759
Provider Name (Legal Business Name): ASHLEY KOSKI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N10565 GRANDVIEW LN
IRONWOOD MI
49938-9622
US

IV. Provider business mailing address

N10565 GRANDVIEW LN
IRONWOOD MI
49938-9622
US

V. Phone/Fax

Practice location:
  • Phone: 906-932-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11470-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: