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NPI Code Detail

MEDICARE: HALEY KOZMINSKI

MEDICARE: HALEY KOZMINSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11038543FL
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4704424811MI
3363LP0808XPsychiatric/Mental Health Nurse Practitioner4043198KY
4363LP0808XPsychiatric/Mental Health Nurse Practitioner0032324OH

General Provider Information

NPI Number : 1215650288
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY KOZMINSKI
Provider Business Mailing Address
First Line : 3567 RESERVE COMMONS DR STE 100
Second Line :
City : MEDINA
State : OH
Zip : 44256-5344
Country : US
Telephone Number : 330-536-3746
Fax Number :
Provider Business Practice Location Address
First Line : 3593 MEDINA RD # 181
Second Line :
City : MEDINA
State : OH
Zip : 44256-8182
Country : US
Telephone Number : 330-536-3746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2022
Last Update Date : 01/12/2026

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Directions to “ HALEY KOZMINSKI ” Practice Location

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