Provider Demographics
NPI:1710368238
Name:KOSICH, CHRISTINA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:KOSICH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:O'SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 5228
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0405
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:
Practice Address - Street 1:5201 PENNELL RD STE C
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-6502
Practice Address - Country:US
Practice Address - Phone:610-876-0347
Practice Address - Fax:610-876-4343
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000948363L00000X
PASP014973363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner