Healthcare Provider Details

I. General information

NPI: 1164338257
Provider Name (Legal Business Name): MOLLY ROSE KOZLOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 CENTRAL AVE
CLEVELAND OH
44115-3044
US

IV. Provider business mailing address

135 E 201ST ST
EUCLID OH
44123-1080
US

V. Phone/Fax

Practice location:
  • Phone: 216-838-1559
  • Fax:
Mailing address:
  • Phone: 330-285-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.383810
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: