Provider Demographics
NPI:1144660051
Name:KOSKELA, KRISTIN NICOLE (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICOLE
Last Name:KOSKELA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:NICOLE
Other - Last Name:MASTIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1946 OLD HOT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0674
Mailing Address - Country:US
Mailing Address - Phone:775-882-1324
Mailing Address - Fax:775-882-9714
Practice Address - Street 1:1475 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4635
Practice Address - Country:US
Practice Address - Phone:775-883-3636
Practice Address - Fax:775-882-2382
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23108207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology