Healthcare Provider Details

I. General information

NPI: 1386813640
Provider Name (Legal Business Name): VIOLETTA KOZLOWSKI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NORTH DUNLAP
MEMPHIS TN
38163-1317
US

IV. Provider business mailing address

50 NORTH DUNLAP
MEMPHIS TN
38163-1317
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-6060
  • Fax:
Mailing address:
  • Phone: 901-287-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number078335
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: