=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225898422
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIRSTI ELIZABETH KOKKO NNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2024
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 910 BLACKFORD ST FL 5
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-1405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-778-5255
-----------------------------------------------------
Fax | 423-778-5366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 910 BLACKFORD ST FL 5
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-1405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-638-9100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LN0000X
-----------------------------------------------------
Taxonomy Name | Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | 40168
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------