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General NPI Number Information
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NPI Number | 1700300357
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Entity Type | Individual
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Provider Name | JORDANN KOKOSKI DO
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2817 ROCK MERRITT AVE
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City | FORT BRAGG
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State | NC
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Zip | 28310-7069
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Country | US
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Telephone | 910-907-8922
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Fax | 910-907-6069
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Provider Business Mailing Address
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Address Line | 2817 ROCK MERRITT AVE
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City | FORT BRAGG
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State | NC
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Zip | 28310-7069
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Country | US
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Telephone | 910-907-1030
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Fax | 910-907-6069
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 83008
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License Number State | GA
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