Individual
GINA MARIE KOSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
HWY 264 MILEPOST 388, POLACCA, AZ 86042-4000
(402) 613-5720
Mailing address
PO BOX 343, POLACCA, AZ 86042-0343
(402) 613-5720
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R183097
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
05/26/2011
Last updated
05/26/2011
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