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Individual

REBECCA JO KOSTYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4130 DUTCHMANS LN, STE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 238-1286
Mailing address
4130 DUTCHMANS LN, STE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 238-1286

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004449
KY
363L00000X
Nurse Practitioner
71006195A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000641811
NRP/ANTHEM
01
000000643662
NOTC/ANTHEM
01
000052152Z
NOTC/HUMANA
01
110584
NOTC./SIHO
05
201289910
IN
01
3764310000
NOTC/PAD
01
50027236
NOTC/PHP
05
7100099350
KY
01
9769702
NRP/CIGNA
Enumeration date
12/20/2006
Last updated
04/28/2016
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