Individual
REBECCA EDWARDS KOSLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2880 UNIVERSITY AVE, MADISON, WI 53705-3644
(608) 698-6171
Mailing address
446 PINE LAWN PKWY, VERONA, WI 53593-9167
(608) 698-6171
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8803
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598784555
UWMF
WI
Enumeration date
09/14/2018
Last updated
01/20/2021
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