Active NPI
Susan Shanahan Kostecki, RN, CNNP
- Critical Care Neonatal Nurse Practitioner
- Carmichael, CA
National Provider Identifier
1992354625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Neonatal Nurse Practitioner
- License
- 7881
- Practice address
- 6501 Coyle Ave
Carmichael, CA 95608-0306 - Phone
- (916) 537-5135
- NPI assigned
- Sep 5, 2019
- Last updated
- Sep 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 7881 | CA | Primary |
Addresses
Primary practice location
6501 Coyle Ave
Carmichael, CA 95608-0306
Mailing address
2221 Raintree CT
Rocklin, CA 95765-4653
Phone (916) 276-8942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7881 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1992354625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 RAINTREE CT",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957654653",
"telephone_number": "916-276-8942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 COYLE AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956080306",
"telephone_number": "916-537-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTECKI",
"first_name": "SUSAN",
"middle_name": "SHANAHAN",
"credential": "RN, CNNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-05",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "CA",
"license": "7881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.