MEDICARE: ERIC LAURENCE KOSTER

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	RN0000141362	TN
2	363LF0000X	Family Nurse Practitioner	APN0000011589	TN

General Provider Information

NPI Number	:	1831184662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC LAURENCE KOSTER

Provider Business Mailing Address
First Line	:	115 MANGRUM DR
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-6162
Country	:	US
Telephone Number	:	931-388-2596
Fax Number	:

Provider Business Practice Location Address
First Line	:	5073 COLUMBIA PIKE
Second Line	:	#100
City	:	SPRING HILL
State	:	TN
Zip	:	37174-8607
Country	:	US
Telephone Number	:	615-302-0885
Fax Number	:	615-891-5003

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	01/25/2011

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Directions to “ ERIC LAURENCE KOSTER ” Practice Location

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