KENNETH W COSTNER (NPI# 1578597100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578597100 |
| Entity Type | Individual |
| Full Name | KENNETH W COSTNER |
| Practice Address |
1610 Orchard Dr Chambersburg PA 17201-9206 |
| Mailing Address |
785 5th Ave Suite 3 Chambersburg PA 17201-4232 |
| Practice Telephone | 7172610929 |
| Practice Fax Number | 7172610902 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 69312 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP013788 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 102982740 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 24 Antrim Commons Dr, Greencastle, PA 172251623 | 7172610929 | 7172610902 |
| 993 Wayne Ave, Chambersburg, PA 172013895 | 7172643278 | 7172624494 |
| 601 E Main St, Waynesboro, PA 172682332 | 7177655088 | 7177655066 |
| 24 Antrim Commons Dr, Greencastle, PA 172251623 | 7175975553 | 7175975522 |
| 46 Walnut Bottom Rd Ste 100, Shippensburg, PA 172578219 | 7174772764 | 7172174207 |
| 1000 Norland Ave, Chambersburg, PA 172014229 | 7172676363 | 7172176937 |
| Street Address |
1610 ORCHARD DR |
| City | CHAMBERSBURG |
| State | PA |
| Zip Code | 17201-9206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740281419 | Theodore M Sofish | Preventive Medicine | 1610 Orchard Dr, Occupational Health Associates, Chambersburg, PA 17201-9206 | 2005-08-03 |
| 1720288293 | Zhiping Mo | Preventive Medicine | 1610 Orchard Dr, Chambersburg, PA 17201-9206 | 2007-07-23 |
| 1871594549 | Francisco G Japzon | Surgery | 1610 Orchard Dr, Occupational Health Associates, Chambersburg, PA 17201-9206 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902496 | Kerin Bielecki | Pharmacist | 1730 Lincoln Way West, Chambersburg, PA 17201 | 2020-11-02 |
| 1750995833 | Emily Suzanne Benfer | Occupational Therapist | 32 Parkwood Drive, Chambersburg, PA 17201 | 2020-09-04 |
| 1225688559 | Oneskin Dermatology LLC | Clinic/Center | 211 Grant Street, Chambersburg, PA 17201 | 2019-09-18 |
| 1679033963 | Hospice of Washington County, Inc. | Hospice Care, Community Based | 209 Grant Street, Chambersburg, PA 17201 | 2019-03-22 |
| 1659837540 | Dialysis Care Center Chambersburg LLC | Clinic/Center | 20 Parkwood Drive, Suite 1, Chambersburg, PA 17201 | 2019-02-15 |
| 1518423623 | Wolter Advanced Dental Care | Durable Medical Equipment & Medical Supplies | 20 Parkwood Dr., Ste 3, Chambersburg, PA 17201 | 2019-02-13 |
| 1972059202 | Lindsey Rae Hyatt | Physician Assistant | 761 Park Fifth Avenue, Chambersburg, PA 17201 | 2016-08-28 |
| 1093176943 | Marcia Rebert | Counselor | 1212 Progress Road, Chambersburg, PA 17201 | 2016-03-18 |
| 1669833471 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 968 Norland Avenue, Chambersburg, PA 17201 | 2016-03-08 |
| 1104283324 | Meagen Louise Stouffer | Acupuncturist | 394 Floral Ave, Chambersburg, PA 17201 | 2016-01-19 |
| Find all providers in zip 17201 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124471305 | Jenelle Fortney | Nurse Practitioner | 761 5th Ave Ste B, Chambersburg, PA 17201-4210 | 2016-07-22 |
| 1235730326 | Justin Baker Rife | Nurse Practitioner | 112 N 7th St, Chambersburg, PA 17201-1720 | 2020-11-04 |
| 1538779921 | Megan Koontz | Nurse Practitioner | 211 Grant St, Chambersburg, PA 17201-1627 | 2020-07-31 |
| 1215559851 | Emily Freeman | Nurse Practitioner | 761 5th Ave Ste F, Chambersburg, PA 17201-4210 | 2020-05-16 |
| 1144870155 | Ashley Hall | Nurse Practitioner | 12 St Paul Dr Ste 208, Chambersburg, PA 17201-1035 | 2019-09-12 |
| 1538718127 | Hilary Weller | Nurse Practitioner | 601 Norland Ave Ste 100, Chambersburg, PA 17201-4235 | 2019-09-06 |
| 1013563980 | Janie Cozzoli | Nurse Practitioner | 120 N 7th St Ste 101, Chambersburg, PA 17201-1795 | 2019-08-15 |
| 1225692940 | Candy Lynn Moschetti | Nurse Practitioner | 820 5th Ave, Chambersburg, PA 17201-4219 | 2019-04-29 |
| 1194282368 | Jacquelynn Ortega | Nurse Practitioner | 22 St Paul Dr Ste 201, Chambersburg, PA 17201-1036 | 2019-02-25 |
| 1780149492 | Fawn Eutzy | Nurse Practitioner | 112 N 7th St, Chambersburg, PA 17201-1720 | 2019-02-06 |
| Find all providers in CHAMBERSBURG | ||||
| City | CHAMBERSBURG |
| Zip Code | 17201 |
Please comment or provide details below to improve the information on KENNETH W COSTNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.