IndividualActive
Blayne Kozelka, PA-C
NPI 1871078667 · Surgical Physician Assistant · La Crosse, WI
Provider details
- NPI number
- 1871078667
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 4522 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1836 South Ave
La Crosse, WI 54601-5429
Phone: (608) 782-7300
Approximate (ZIP-level) locationGet directions
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Registry dates
- Enumerated
- 2018-09-27
- Last updated
- 2018-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.