Provider Demographics
NPI:1083505580
Name:KOZLOWSKI, LANDEN ALYSE (RN, BSN)
Entity type:Individual
Prefix:
First Name:LANDEN
Middle Name:ALYSE
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 S JONATHAN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5683
Mailing Address - Country:US
Mailing Address - Phone:409-656-1076
Mailing Address - Fax:
Practice Address - Street 1:3810 S JONATHAN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5683
Practice Address - Country:US
Practice Address - Phone:409-656-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program