BRENDA JEAN KOZAK (NPI# 1104378744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104378744 |
| Entity Type | Individual |
| Full Name | BRENDA JEAN KOZAK |
| Credential | FNP-C |
| Practice Address |
134 Elon Rd Madison Heights VA 24572-2536 |
| Practice Telephone | 4349291400 |
| Practice Fax Number | 4344552487 |
| Mailing Telephone | 4349291400 |
| Mailing Fax Number | 4344552487 |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2017-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024174182 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477508075 | Brenda Kauffman Kozak | Nurse Practitioner | 2605 Keiser Blvd, Wyomissing, PA 19610 | 2006-05-23 |
| Street Address |
134 ELON RD |
| City | MADISON HEIGHTS |
| State | VA |
| Zip Code | 24572-2536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104918887 | Duane Kresge | Nurse Practitioner | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2006-09-29 |
| 1699303222 | Jessica Leigh Phillips | Nurse Practitioner | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2020-03-30 |
| 1326675026 | Lynn Sofia Olmsted | Midwife | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2020-03-24 |
| 1053969188 | Jennifer Lynn Shumate | Nurse Practitioner | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2019-09-02 |
| 1750784880 | Rikki Mcconnell | Nurse Practitioner | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2014-10-03 |
| 1164868485 | Malorie Lyn Sridhar | Family Medicine | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2013-05-14 |
| 1972858660 | Johnson Health Center | Clinic/Center | 134 Elon Rd, Madison Heights, VA 24572-2536 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821544453 | Select Rehab | Assisted Living Facility | 268 Hilltop Dr, Madison Heights, VA 24572 | 2016-09-01 |
| 1740421031 | Deborah Lynch Fletcher | Nurse's Aide | 5068 South Amherst Hwy, Madison Heights, VA 24572 | 2009-03-16 |
| 1710143854 | Commonwealth Chiropractic Center, Inc. | Chiropractor | 3756 South Amherst Highway, Suite 100, Madison Heights, VA 24572 | 2008-07-29 |
| 1174689020 | Sunrise Adult Day Care Center | Durable Medical Equipment & Medical Supplies | 4830 South Amherst Hwy, Madison Heights, VA 24572 | 2006-12-28 |
| 1942385786 | Madison Heights Eye Care PC Optometrists | Optometrist | 5076 South Amherst Hwy, Madison Heights, VA 24572 | 2006-10-26 |
| 1710078183 | Patricia L Evans | Pharmacist | 521 Colony Rd Rt 210 East, Madison Heights, VA 24572 | 2006-09-28 |
| 1952407330 | Fredrick P Reynolds | Optometrist | 5076 S. Amherst Highway, Madison Heights, VA 24572 | 2006-09-15 |
| 1740384957 | Centra Health Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1410 Kentmoor Farm Rd, Madison Heights, VA 24572 | 2006-09-08 |
| 1891725370 | Amy N French | Social Worker | 3742 S Amherst Hwy, Madison Heights, VA 24572 | 2006-07-03 |
| 1730610841 | Janna Laverdiere | Dentist | 239 Trojan Rd, Madison Heights, VA 24572 | 2017-03-21 |
| Find all providers in zip 24572 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568996650 | Sarah Harris | Nurse Practitioner | 69 E Harwood Ave, Madison Heights, MI 48071-4027 | 2017-04-14 |
| 1194266957 | Aminur Rahman | Nurse Practitioner | 350 E Twelve Mile Rd, Madison Heights, MI 48071-1833 | 2017-03-13 |
| 1447629381 | Rosily Samji | Nurse Practitioner | 1724 E 13 Mile Rd, Madison Heights, MI 48071-1538 | 2015-09-22 |
| 1942689492 | Maria Parsons | Nurse Practitioner | 27765 Rialto St, Madison Heights, MI 48071-3441 | 2015-05-28 |
| 1376160341 | Kristen Grace Fuelling | Nurse Practitioner | 350 E 12 Mile Rd, Madison Heights, MI 48071-2531 | 2020-06-25 |
| 1548882905 | Brittney Sanders | Nurse Practitioner | 30581 Stephenson Hwy, Madison Heights, MI 48071-1610 | 2020-05-08 |
| 1285019653 | Erika Prisco | Nurse Practitioner | 27355 John R Rd, Madison Heights, MI 48071 | 2015-07-27 |
| 1861872004 | Tyffany Bedford | Nurse Practitioner | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2015-06-03 |
| 1710259189 | Lisa Ann Boone | Nurse Practitioner | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2012-02-01 |
| 1487752010 | Carin Schofield | Nurse Practitioner | 118 Oakwood Dr, Suitea, Madison Heights, VA 24572-3001 | 2006-09-20 |
| Find all providers in MADISON HEIGHTS | ||||
| City | MADISON HEIGHTS |
| Zip Code | 24572 |
Please comment or provide details below to improve the information on BRENDA JEAN KOZAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.