Healthcare Provider Details

I. General information

NPI: 1003612193
Provider Name (Legal Business Name): LEXI LEE KOSTAL RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEXI LEE PASTIZZO NONE

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 W OLD COUNTY RD
BELHAVEN NC
27810-1232
US

IV. Provider business mailing address

501 W MAIN ST
WASHINGTON NC
27889-4833
US

V. Phone/Fax

Practice location:
  • Phone: 252-943-0600
  • Fax:
Mailing address:
  • Phone: 860-604-7407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5021738
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: