Provider Demographics
NPI:1841712213
Name:KOZLOW, RHONDA ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ANN
Last Name:KOZLOW
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 1:234 JONES RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5707
Mailing Address - Country:US
Mailing Address - Phone:518-727-6171
Mailing Address - Fax:
Practice Address - Street 1:234 JONES RD
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5707
Practice Address - Country:US
Practice Address - Phone:518-727-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY538749163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse