Provider Demographics
NPI:1417686387
Name:KOSSMANN, EMILY N (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:KOSSMANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:201 BJC SAINT PETERS DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-3386
Practice Address - Country:US
Practice Address - Phone:636-916-9615
Practice Address - Fax:636-916-9850
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2022018218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2022018218OtherMISSOURI STATE BOARD OF NUJRSING