Mary Jo Koszarek, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R-130517-3 Issued in MN

Practice address

927 Trettel LN
Fond Du Lac Human Services Division
Cloquet, MN 55720-1345

Phone

(218) 879-1227

Fax

(218) 878-2188

NPI assigned

Apr 5, 2006

Last updated

May 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1487616363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 12TH ST",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202040",
            "telephone_number": "218-879-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LN",
            "address_2": "FOND DU LAC HUMAN SERVICES DIVISION",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227",
            "fax_number": "218-878-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSZAREK",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-130517-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699316800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Klug, DNP
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• Jamie Johanna Kraus, PHARMD
• Natalie Krier Arreola, MD
• Kristel Ellen Kubis

• Family Nurse Practitioner in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.