# NINA KODROS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326678962
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 10003744A | IN | Yes |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 11/07/2023