MEDICARE: MS. MICHELLE COSLIN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN-554115	TX

General Provider Information

NPI Number	:	1215125596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE COSLIN RN

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 1420
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2326
Country	:	US
Telephone Number	:	713-794-0368
Fax Number	:	713-794-0423

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 1420
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2326
Country	:	US
Telephone Number	:	713-794-0368
Fax Number	:	713-794-0423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	10/11/2007

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