Individual
KATHLEEN M COST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
573 HORSE THIEF RUN ROAD, WELLSBORO, PA 16901-7891
(570) 724-4860
Mailing address
573 HORSE THIEF RUN ROAD, WELLSBORO, PA 16901-7891
(570) 724-4860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP006274C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01779120
BLUE SHIELD
PA
01
—
P00268213
RR MEDICARE
PA
Enumeration date
09/20/2006
Last updated
11/09/2012
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