Individual
MRS. MARY JO KOSZAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
927 TRETTEL LN, FOND DU LAC HUMAN SERVICES DIVISION, CLOQUET, MN 55720-1345
(218) 879-1227
(218) 878-2188
Mailing address
324 12TH ST, CLOQUET, MN 55720-2040
(218) 879-0977
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R-130517-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699316800
—
MN
Enumeration date
04/05/2006
Last updated
05/24/2013
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