Provider Demographics
NPI:1851851513
Name:KOUZMINA, IRINA (RN)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:KOUZMINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 HOYER DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-9222
Mailing Address - Country:US
Mailing Address - Phone:941-807-4847
Mailing Address - Fax:
Practice Address - Street 1:4835 HOYER DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34241-9222
Practice Address - Country:US
Practice Address - Phone:941-807-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9353894163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty