Provider Demographics
NPI:1417479866
Name:COSS, KAYLA JO
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JO
Last Name:COSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-3563
Mailing Address - Country:US
Mailing Address - Phone:740-381-4420
Mailing Address - Fax:
Practice Address - Street 1:1060 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3563
Practice Address - Country:US
Practice Address - Phone:740-381-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide