Provider Demographics
NPI:1851871156
Name:KOSEK, JAN
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:KOSEK
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 1:69 E BEAU ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4711
Mailing Address - Country:US
Mailing Address - Phone:724-223-5115
Mailing Address - Fax:724-223-5119
Practice Address - Street 1:69 E BEAU ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4711
Practice Address - Country:US
Practice Address - Phone:724-223-5115
Practice Address - Fax:724-223-5119
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN636828163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health