Provider Demographics
NPI:1982422754
Name:KOSTER, LAURA ANN (RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:KOSTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11671 FINKBEINER RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-9738
Mailing Address - Country:US
Mailing Address - Phone:616-706-6263
Mailing Address - Fax:
Practice Address - Street 1:15540 LAKE MICHIGAN DR
Practice Address - Street 2:
Practice Address - City:WEST OLIVE
Practice Address - State:MI
Practice Address - Zip Code:49460-9520
Practice Address - Country:US
Practice Address - Phone:616-706-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704277717163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty