Individual
MARA RENAE KOZISEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
802 KENYON RD, FORT DODGE, IA 50501-5740
(515) 573-3101
Mailing address
2923 DODGER DR UNIT 2, FORT DODGE, IA 50501-6346
(641) 512-1280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
134822
IA
Other
Enumeration date
04/02/2025
Last updated
01/26/2026
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