Individual provider · Type 1 NPI
Mackenzee Koselke, PA-C
Physician Assistant · Wanatah, IN
Practice location
11783 W 1600 S
Wanatah, IN 46390-9671
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant Primary | 363A00000X | 10005464A (IN) |
Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…
About NPI 1376454215
Mackenzee Koselke, PA-C's National Provider Identifier is 1376454215, issued on Sep 16, 2026. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Wanatah, IN. The record was last updated on Sep 16, 2026.