Individual
MAUREEN ANN KOSIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1007 4TH AVE S, WISHEK, ND 58495-7527
(701) 452-2364
(701) 452-4276
Mailing address
201 8TH ST NE, BYRON, MN 55920-1443
(507) 775-6294
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0274
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAC0274
LICER SE
ND
Enumeration date
08/18/2010
Last updated
08/18/2010
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