Provider Demographics
NPI:1174546147
Name:KOSTER, TRUDY M (PA)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:M
Last Name:KOSTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2404 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1526
Mailing Address - Country:US
Mailing Address - Phone:406-784-2346
Mailing Address - Fax:406-784-2711
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4200
Practice Address - Country:US
Practice Address - Phone:406-247-3200
Practice Address - Fax:406-247-3200
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MTFNP326363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP45385Medicare UPIN