Provider Demographics
NPI:1841755683
Name:KOSKI, JESSICA S (BS, IBCLC, DOULA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:S
Last Name:KOSKI
Suffix:
Gender:F
Credentials:BS, IBCLC, DOULA
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:S
Other - Last Name:HULDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 NEEDLE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-5151
Mailing Address - Country:US
Mailing Address - Phone:419-704-8105
Mailing Address - Fax:912-200-7898
Practice Address - Street 1:813 E 66TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4507
Practice Address - Country:US
Practice Address - Phone:419-704-8105
Practice Address - Fax:912-200-5873
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
GA174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty