Individual
LYNN WYNNE KOSANOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
930 SW 9TH AVENUE, ALBANY, OR 97321
(541) 926-9611
(541) 926-6152
Mailing address
930 SW 9TH AVENUE, ALBANY, OR 97321
(541) 926-9611
(541) 926-6152
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
82012809
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
082012809
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213481
—
OR
Enumeration date
07/18/2006
Last updated
12/15/2010
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