Provider Demographics
NPI:1437183712
Name:KOSKINIEMI, PATRICIA G (APNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:KOSKINIEMI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:G
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 OSCEOLA STREET
Mailing Address - Street 2:
Mailing Address - City:LAURIUM
Mailing Address - State:MI
Mailing Address - Zip Code:49913-2134
Mailing Address - Country:US
Mailing Address - Phone:906-337-6560
Mailing Address - Fax:906-337-6562
Practice Address - Street 1:205 OSCEOLA STREET
Practice Address - Street 2:
Practice Address - City:LAURIUM
Practice Address - State:MI
Practice Address - Zip Code:49913-2134
Practice Address - Country:US
Practice Address - Phone:906-337-7000
Practice Address - Fax:906-337-6562
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195331363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1437183712Medicaid
MI4704195331OtherSTATE LICENSE NUMBER
MIM28290041Medicare PIN