Provider Demographics
NPI:1649054131
Name:KOLODZIEJSKI, FLORENCE RENEE
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:RENEE
Last Name:KOLODZIEJSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 REDMILL DR
Mailing Address - Street 2:APT B
Mailing Address - City:SOUTH LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45065
Mailing Address - Country:US
Mailing Address - Phone:828-388-3978
Mailing Address - Fax:
Practice Address - Street 1:1028 REDMILL DR
Practice Address - Street 2:APT B
Practice Address - City:SOUTH LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45065
Practice Address - Country:US
Practice Address - Phone:828-388-3978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle