Provider Demographics
NPI:1124591524
Name:KOZLOSKY, JOSEPH (APNP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:KOZLOSKY
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10827 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-1127
Mailing Address - Country:US
Mailing Address - Phone:414-541-6010
Mailing Address - Fax:414-541-5509
Practice Address - Street 1:10827 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1127
Practice Address - Country:US
Practice Address - Phone:414-541-6010
Practice Address - Fax:414-541-5509
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8977-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner