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General NPI Number Information
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NPI Number | 1790381747
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Entity Type | Individual
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Provider Name | ANDREA KOZIKOWSKI NAUGHTON
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 15855 19 MILE RD
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City | CLINTON TWP
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State | MI
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Zip | 48038-3504
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Country | US
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Telephone | 586-263-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 6653 COLLEGE PARK
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City | CLARKSTON
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State | MI
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Zip | 48346-1066
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Country | US
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Telephone | 586-291-0598
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704297249
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License Number State | MI
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