MEDICARE: JEANNIE KOSINT

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	363LF0000X	Family Nurse Practitioner	AP8152	AZ

General Provider Information

NPI Number	:	1790154615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE KOSINT

Provider Business Mailing Address
First Line	:	21045 N 9TH PL
Second Line	:	STE 205
City	:	PHOENIX
State	:	AZ
Zip	:	85024-5634
Country	:	US
Telephone Number	:	866-465-4881
Fax Number	:	877-300-8768

Provider Business Practice Location Address
First Line	:	21045 N 9TH PL
Second Line	:	STE 205
City	:	PHOENIX
State	:	AZ
Zip	:	85024-5634
Country	:	US
Telephone Number	:	866-465-4881
Fax Number	:

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

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	10/05/2016

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Directions to “ JEANNIE KOSINT ” Practice Location

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