Provider Demographics
NPI:1235653809
Name:KOZULA, ELAINE C (NMD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:C
Last Name:KOZULA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 S PRICE RD APT 173
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6156
Mailing Address - Country:US
Mailing Address - Phone:480-749-3337
Mailing Address - Fax:
Practice Address - Street 1:1750 S PRICE RD APT 173
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6156
Practice Address - Country:US
Practice Address - Phone:480-749-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH118175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH118OtherNH BOARD OF NATUROPATHIC EXAMINERS