Kelly Jo Koss
Nurse Practitioner - Women's Health
4502 Medical Dr
San Antonio
, Texas 78229-4402
Kelly Jo Koss
Nurse Practitioner - Women's Health
4502 Medical Dr
San Antonio
, Texas 78229-4402
(210) 450-9000
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Kelly Jo Koss
- 7703 Floyd Curl Dr Mc7977
- San Antonio, TX
- Zip : 78229-3901
- Phone : (210) 450-9000
Second Address
- Kelly Jo Koss
- 4502 Medical Dr
- San Antonio, TX
- Zip : 78229-4402
- Fax : (210) 358-4727
- Phone : (210) 358-1473
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | 811550 | TX |
National Provider Identifier
| NPI | 1023367208 |
|---|---|
| Provider Name | Kelly Jo Koss |
| First Address | San Antonio, TX 78229-3901 |
| Second Address | San Antonio, TX 78229-4402 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/09/2012 |
| Last Update Date | 17/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 306678901 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.