Individual
MARTHA SOCORRO KOZUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5514 HOHMAN AVE., HAMMOND, IN 46320
(219) 933-2018
(219) 933-2647
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000129A
IN
Other
Enumeration date
05/02/2007
Last updated
03/19/2021
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