Koszarek, Mary Jo

Koszarek, Mary Jo is an individual health care provider with primary practice located at 927 Trettel Ln Fond Du Lac Human Services Division, Cloquet MN 55720-1345. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Koszarek, Mary Jo can be contacted via phone (218) 879-1227.

Contact Information

Primary practice address
927 Trettel Ln Fond Du Lac Human Services Division Cloquet MN 55720-1345
Phone: (218) 879-1227
Fax: (218) 878-2188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R-130517-3 Minnesota

Profile Details

NPI number 1487616363
LBN Legal business name Koszarek, Mary Jo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated May 24th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487616363 NPPES
Minnesota MEDICAID 699316800

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