Individual
KATRINA M KOZUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6375 US HIGHWAY 6, PORTAGE, IN 46368-5217
(219) 762-3196
(219) 763-6438
Mailing address
6375 US HIGHWAY 6, PORTAGE, IN 46368-5217
(219) 762-3196
(219) 763-6438
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003431A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201059470
—
IN
Enumeration date
10/25/2010
Last updated
04/11/2022
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