MEDICARE: ANNE MARIE KOSTER FNP

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	AP1816	AZ
2	363LF0000X	Family Nurse Practitioner	NP-803A	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790739951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MARIE KOSTER FNP

Provider Business Mailing Address
First Line	:	3340 EAST GOLDSTONE WAY
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-1026
Country	:	US
Telephone Number	:	208-367-5170
Fax Number	:	208-367-5180

Provider Business Practice Location Address
First Line	:	3025 WEST CHERRY LANE
Second Line	:	SUITE B
City	:	MERIDIAN
State	:	ID
Zip	:	83642-8531
Country	:	US
Telephone Number	:	208-367-8550
Fax Number	:	208-367-8555

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	06/16/2009

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Directions to “ ANNE MARIE KOSTER FNP” Practice Location

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