Provider Demographics
NPI:1669022356
Name:KOSIEROWSKI, TAFFY
Entity Type:Individual
Prefix:
First Name:TAFFY
Middle Name:
Last Name:KOSIEROWSKI
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:PO BOX 8573
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-8551
Mailing Address - Country:US
Mailing Address - Phone:801-673-0457
Mailing Address - Fax:
Practice Address - Street 1:1036 E 7625 S
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-2957
Practice Address - Country:US
Practice Address - Phone:801-673-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider