Provider Demographics
NPI:1073831558
Name:KOSTELNIK, LAUREN F (DO)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:F
Last Name:KOSTELNIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HOSPITAL DR
Mailing Address - Street 2:STE 200C
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-7676
Mailing Address - Country:US
Mailing Address - Phone:859-737-6481
Mailing Address - Fax:859-737-6640
Practice Address - Street 1:225 HOSPITAL DR
Practice Address - Street 2:STE 200C
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-7676
Practice Address - Country:US
Practice Address - Phone:859-737-6481
Practice Address - Fax:859-737-6640
Is Sole Proprietor?:No
Enumeration Date:2010-05-09
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY03568208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics