Individual
BECKY KOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7085
(262) 948-7086
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7085
(262) 948-7086
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
132982-30
WI
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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