Provider Demographics
NPI:1891264727
Name:KOSKENMAKI, LAURA ANN (FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:KOSKENMAKI
Suffix:
Gender:F
Credentials:FNP
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 1878
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:AK
Mailing Address - Zip Code:99559-1878
Mailing Address - Country:US
Mailing Address - Phone:907-545-3049
Mailing Address - Fax:
Practice Address - Street 1:17A LITTLE STRAWBERRY LN
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229
Practice Address - Country:US
Practice Address - Phone:360-543-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010237363LF0000X
AK141905363LF0000X
WAAP60763367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily