Individual
MICHAELENE CATHERINE KOCZARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53183 KAKOS DR, CHESTERFIELD, MI 48051-3941
(586) 646-5440
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
4704296738
MI
363L00000X
Nurse Practitioner
Primary
4704296738
MI
Other
Enumeration date
04/16/2019
Last updated
11/22/2024
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