Kozub, Katrina M
Kozub, Katrina M is an individual health care provider with primary practice located at 6375 Us Highway 6 , Portage IN 46368-5217. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kozub, Katrina M can be contacted via phone (219) 762-3196.Contact Information
Primary practice address
6375 Us Highway 6
Portage IN 46368-5217
Phone: (219) 762-3196
Fax: (219) 763-6438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71003431A | Indiana |
Profile Details
| NPI number | 1508166547 |
|---|---|
| LBN Legal business name | Kozub, Katrina M |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2010 |
| Last updated | Apr 11th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508166547 | NPPES |
| Indiana | MEDICAID | 201059470 |
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