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NPI Code Detail

MEDICARE: NICOLE KOZAK VU RN, CPNP-AC

MEDICARE: NICOLE KOZAK VU RN, CPNP-AC
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
1163W00000XRegistered Nurse734058TX
2363L00000XNurse PractitionerAP115114TX
3363LP0222XCritical Care Pediatric Nurse PractitionerAP115114TX

General Provider Information

NPI Number : 1740359512
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE KOZAK VU RN, CPNP-AC
Provider Business Mailing Address
First Line : 7777 FOREST LN STE C300J
Second Line :
City : DALLAS
State : TX
Zip : 75230-2604
Country : US
Telephone Number : 972-566-2043
Fax Number : 972-566-7437
Provider Business Practice Location Address
First Line : 7777 FOREST LN STE C300J
Second Line :
City : DALLAS
State : TX
Zip : 75230-2604
Country : US
Telephone Number : 972-566-2043
Fax Number : 972-566-7437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/25/2024

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