1902102320 NPI number — MRS. ROBYN LAURELLE KOSER M.ED.

Table of content: MRS. ROBYN LAURELLE KOSER M.ED. (NPI 1902102320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902102320 NPI number — MRS. ROBYN LAURELLE KOSER M.ED.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOSER
Provider First Name:
ROBYN
Provider Middle Name:
LAURELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KOSER
Provider Other First Name:
ROBYN
Provider Other Middle Name:
FOLSOM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1902102320
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1290 MAIN ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
DAPHNE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36526-8623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-625-0118
Provider Business Mailing Address Fax Number:
251-625-0116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1290 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
DAPHNE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36526-8623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-625-0118
Provider Business Practice Location Address Fax Number:
251-625-0116
Provider Enumeration Date:
02/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  2899 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 2899 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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