Provider Demographics
NPI:1437947520
Name:KOZELKA, ANNABELLE CLAIRE
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:CLAIRE
Last Name:KOZELKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7175 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8074
Mailing Address - Country:US
Mailing Address - Phone:916-259-6438
Mailing Address - Fax:
Practice Address - Street 1:7175 MOORE RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8074
Practice Address - Country:US
Practice Address - Phone:916-259-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant