Individual provider · Type 1 NPI
Kelly Joan Koustas
Licensed Practical Nurse · Detroit, MI
NPI number
1528437597
Active
Practice location
751 E Grand Blvd
Detroit, MI 48207-2529
Mailing address
24616 Notre Dame
Dearborn, MI 48124
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 4703110676 (MI) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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About NPI 1528437597
Kelly Joan Koustas's National Provider Identifier is 1528437597, issued on Sep 21, 2015. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Detroit, MI. The record was last updated on Sep 21, 2015.