| Doctor Name: | JENNIFER DENISE KOZLICA |
| NPI Number: | 1003038787 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MPH |
| License Number: | 0000124675 |
| Business Practice Address: | 540 Mccallie Ave Suite 450 Chattanooga, TN - 374022089 |
| Business Phone Number: | 4236345831 |
| Business Fax Number: | 4236343139 |
| Mailing Address: | 110 La Porte Dr, CHATTANOOGA |
| State: | TN |
| Postal Code: | 374151304 |
| Phone Number: | 4232800470 |
| Fax Number: | 4236343139 |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 0000124675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |