Provider Demographics
NPI:1134337207
Name:KOSTER, SUSAN SOMMERS (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:SOMMERS
Last Name:KOSTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MAY APPLE DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3457
Mailing Address - Country:US
Mailing Address - Phone:610-873-7455
Mailing Address - Fax:
Practice Address - Street 1:2700 FUNKS RD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-2834
Practice Address - Country:US
Practice Address - Phone:215-368-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009019363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health