Provider Demographics
NPI:1396539862
Name:KOESHALL, JOSEPHINE NICOLE (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:NICOLE
Last Name:KOESHALL
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 SHANDALYN LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7922
Mailing Address - Country:US
Mailing Address - Phone:406-600-3982
Mailing Address - Fax:
Practice Address - Street 1:4600 SHANDALYN LN
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7922
Practice Address - Country:US
Practice Address - Phone:406-600-3982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife