Kozlow, Maureen

Kozlow, Maureen is an individual health care provider with primary practice located at 1500 S Lake Park Ave Ste 110 , Hobart IN 46342-6638. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kozlow, Maureen can be contacted via phone (219) 947-6017.

Contact Information

Primary practice address
1500 S Lake Park Ave Ste 110 Hobart IN 46342-6638
Phone: (219) 947-6017
Fax: (219) 947-6018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 00000000A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10003398A Indiana

Profile Details

NPI number 1659040020
LBN Legal business name Kozlow, Maureen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2021
Last updated Oct 7th, 2021 - about 4 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 1659040020 NPPES
Indiana MEDICAID 300054941

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