Individual
COREY T KOCISKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 528-2541
Mailing address
7312 MARTINGALE DR, POWELL, TN 37849-5159
(731) 307-0360
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
143807
GA
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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