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General NPI Number Information
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NPI Number | 1003612193
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Entity Type | Individual
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Provider Name | LEXI LEE KOSTAL RN, NP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 317 WESTERN BLVD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6338
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Country | US
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Telephone | 910-577-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 501 W MAIN ST
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City | WASHINGTON
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State | NC
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Zip | 27889-4833
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Country | US
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Telephone | 860-604-7407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021738
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License Number State | NC
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