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Individual

JACQUELINE J KOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1301 MCARTHUR ST, MANCHESTER, TN 37355-2425
(931) 728-6800
(931) 728-2911
Mailing address
PO BOX 1065, MANCHESTER, TN 37349-1065
(931) 728-6800
(931) 728-2911

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
APN0000007514
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3348574
TN
01
4102275
BCBS
TN
Enumeration date
04/28/2006
Last updated
10/02/2012
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