Provider Demographics
NPI:1225514995
Name:DITS-RINTA-KOSKI, JANET ANNIKKI (RN, MSN, AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ANNIKKI
Last Name:DITS-RINTA-KOSKI
Suffix:
Gender:F
Credentials:RN, MSN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 SAINT JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2898
Mailing Address - Country:US
Mailing Address - Phone:678-347-3039
Mailing Address - Fax:
Practice Address - Street 1:1395 S MARIETTA PKWY SE STE 730
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-7886
Practice Address - Country:US
Practice Address - Phone:770-688-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA169381363LA2200X, 363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care