Individual
AMY D KOSANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-5261
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-5261
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN138246
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084271
—
AZ
01
—
P00321421
RAILROAD MEDICARE
AZ
Enumeration date
04/21/2006
Last updated
01/27/2010
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