Provider Demographics
NPI:1841166766
Name:KOZAKIEWICZ, DOMINIKA KATARZYNA
Entity type:Individual
Prefix:
First Name:DOMINIKA
Middle Name:KATARZYNA
Last Name:KOZAKIEWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DOMINIKA
Other - Middle Name:KATARZYNA
Other - Last Name:LIGEZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:1840 MEDICAL CENTER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3237
Practice Address - Country:US
Practice Address - Phone:615-848-0488
Practice Address - Fax:615-904-9061
Is Sole Proprietor?:No
Enumeration Date:2025-10-16
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily