Individual
SUSAN SHANAHAN KOSTECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNNP
Contact information
Practice address
6501 COYLE AVE, CARMICHAEL, CA 95608-0306
(916) 537-5135
Mailing address
2221 RAINTREE CT, ROCKLIN, CA 95765-4653
(916) 276-8942
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
7881
CA
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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