Provider Demographics
NPI:1912250101
Name:KOSTA, MEGAN (FNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KOSTA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 DENNISON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3497
Mailing Address - Country:US
Mailing Address - Phone:614-564-9067
Mailing Address - Fax:
Practice Address - Street 1:1020 DENNISON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3497
Practice Address - Country:US
Practice Address - Phone:614-564-9067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.369035-COA1163W00000X
OHCOA.13755-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse