Provider Demographics
NPI:1871897769
Name:'HEMOSTASIS OASIS'
Entity type:Organization
Organization Name:'HEMOSTASIS OASIS'
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KOZAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:336-414-3337
Mailing Address - Street 1:764 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-6075
Mailing Address - Country:US
Mailing Address - Phone:336-414-3337
Mailing Address - Fax:336-245-8366
Practice Address - Street 1:764 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-6075
Practice Address - Country:US
Practice Address - Phone:336-414-3337
Practice Address - Fax:336-245-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002413363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty