Individual
LANE R KOCOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
8600 EVERGREEN BLVD NW, COON RAPIDS, MN 55433-6036
(763) 260-5113
Mailing address
10 W MARKET ST STE 2900, INDIANAPOLIS, IN 46204-2964
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11225
MN
363LF0000X
Family Nurse Practitioner
26NJ01169000
NJ
Other
Enumeration date
07/11/2021
Last updated
04/10/2026
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