Kim Kossakowski

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

ARNP 3025202 Issued in FL

Practice address

4266 Sunbeam Rd
Jacksonville, FL 32257-2425

Phone

(904) 268-5200

Fax

(904) 407-6007

NPI assigned

Jan 26, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Kim Elizabeth Bennett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1376933630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-268-5200",
            "fax_number": "904-407-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-268-5200",
            "fax_number": "904-407-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSAKOWSKI",
        "first_name": "KIM",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP 3025202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "BENNETT",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Kosilla, CRNA
• Robert Michael Kosinski, MD
• Harry M Koslowski, MD
• Bilal Kosovac, MS, LMHC, NCC
• Anastasia Dionne Kosowski
• Semaan Georges Kosseifi, M.D.
• Carissa J Kostecki, MD
• David A Kostick, MD
• Alexandra M Kostur, M.D.
• Mariya Kotova, PHARMD

• Primary Care Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.