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Individual

MR. GUS ANGELO KOSTAS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., CRNP

Contact information

Practice address
1523 W RIDGE AVE, SHARPSVILLE, PA 16150-1066
(724) 456-7742
Mailing address
1523 W RIDGE AVE, SHARPSVILLE, PA 16150-1066
(724) 456-7742

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1114946
KY
363LF0000X
Family Nurse Practitioner
AP1977
AZ
363LF0000X
Family Nurse Practitioner
NP-06532
OH
363LF0000X
Family Nurse Practitioner
Primary
TP006397B
PA

Other

Enumeration date
12/13/2005
Last updated
11/01/2013
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