Healthcare Provider Details

I. General information

NPI: 1447888524
Provider Name (Legal Business Name): LAUREN KOZLOWSKI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 CENTRE AVE STE 610
PITTSBURGH PA
15232-1326
US

IV. Provider business mailing address

426 SAMPLE ST
PITTSBURGH PA
15209-2340
US

V. Phone/Fax

Practice location:
  • Phone: 412-651-2809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN653428
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP021521
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: