Individual
MS. LORYJEAN M KOSTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 252-7458
(608) 258-6772
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-6624
(414) 805-9000
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
105203-030
WI
367A00000X
Advanced Practice Midwife
Primary
105203-032
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669589107
—
WI
Enumeration date
08/23/2006
Last updated
12/04/2020
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