Individual
GWENDOLYN MARTINIQUE KOSEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6603
(651) 495-6201
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 495-6603
(952) 853-8727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1237131
MN
Other
Enumeration date
09/08/2005
Last updated
01/14/2019
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