Individual
MS. KATHERINE JUSTINE NOWAKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7250 CLEARVISTA DR, INDIANAPOLIS, IN 46256-4692
(317) 621-5673
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10004053A
IN
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300079235
—
IN
Enumeration date
05/18/2023
Last updated
03/24/2026
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