MEDICARE: STEPHANIE MARIE KOZEL RN

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
1	163W00000X	Registered Nurse	273258	TN
2	363LF0000X	Family Nurse Practitioner	41604	TN

General Provider Information

NPI Number	:	1801655329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MARIE KOZEL RN

Provider Business Mailing Address
First Line	:	1401 3RD AVE N APT 310
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37208-3278
Country	:	US
Telephone Number	:	724-882-7130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 GLENBROOK WAY STE 130
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-1318
Country	:	US
Telephone Number	:	615-505-4882
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	06/22/2026

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