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Individual

KENT KOSMATKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
3333 W DEYOUNG ST, MARION, IL 62959-5884
(660) 826-5960
(660) 826-4852
Mailing address
PO BOX 503256, SAINT LOUIS, MO 63150-0001
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209000291
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
26167
SC

Other

Enumeration date
12/21/2005
Last updated
01/17/2025
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