Individual
MIA M KOZOJED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-5121
(701) 234-5124
Mailing address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-5121
(701) 234-5124
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R30620
ND
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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