Individual
SHANNA D. KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
250 PARK STREET, BOWLING GREEN, KY 42101-1780
(270) 796-6540
(270) 796-6576
Mailing address
250 PARK STREET, BOWLING GREEN, KY 42101-1780
(270) 796-6540
(270) 796-6576
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3006749
KY
363LA2100X
Acute Care Nurse Practitioner
15685
TN
363LA2100X
Acute Care Nurse Practitioner
3006749
KY
Other
Enumeration date
03/10/2011
Last updated
11/27/2013
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