Provider Demographics
NPI:1205830866
Name:NIMPTSCH-KOSSEK, IWONA (MD)
Entity Type:Individual
Prefix:DR
First Name:IWONA
Middle Name:
Last Name:NIMPTSCH-KOSSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1179
Mailing Address - Country:US
Mailing Address - Phone:719-776-4646
Mailing Address - Fax:719-776-4640
Practice Address - Street 1:3027 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1179
Practice Address - Country:US
Practice Address - Phone:719-776-4646
Practice Address - Fax:719-776-4640
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41419207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99954273Medicaid
CO44205881Medicaid
CO41419OtherLICENSE
BN5446693OtherDEA #
CO44205881Medicaid
COC804382Medicare PIN