Doctor Name: | ALLISON K. KOZELKA |
NPI Number: | 1396045035 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 004528 |
Business Practice Address: | 1776 Boston Tpke Coventry, CT - 062381160 |
Business Phone Number: | 8607420807 |
Business Fax Number: | 8607428702 |
Mailing Address: | 1776 Boston Tpke, COVENTRY |
State: | CT |
Postal Code: | 062381160 |
Phone Number: | 8607420807 |
Fax Number: | 8607428702 |
NPI Enumeration Date: | 10/28/2010 |
NPI Last Update Date: | 08/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 004528 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |