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Individual

MS. ERICA ALEXANDER KOSTMAYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
401 COWAN RD UNIT B, GULFPORT, MS 39507-2022
(228) 202-1144
Mailing address
401 COWAN RD UNIT B, GULFPORT, MS 39507-2022
(228) 202-1144

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
1-156402
AL
363LP0200X
Pediatric Nurse Practitioner
Primary
904935
MS

Other

Enumeration date
03/19/2021
Last updated
12/10/2021
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