Provider Demographics
NPI:1821381203
Name:KOSTER, NELDA
Entity Type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:
Last Name:KOSTER
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 1:601 MOSSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-8329
Mailing Address - Country:US
Mailing Address - Phone:702-293-7466
Mailing Address - Fax:
Practice Address - Street 1:601 MOSSWOOD DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-8329
Practice Address - Country:US
Practice Address - Phone:702-293-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst