Provider Demographics
NPI:1558796235
Name:COZART, ANGELA (NP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:COZART
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TALBOTTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8749
Mailing Address - Country:US
Mailing Address - Phone:706-641-6900
Mailing Address - Fax:706-327-0757
Practice Address - Street 1:1130 TALBOTTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8749
Practice Address - Country:US
Practice Address - Phone:706-641-6900
Practice Address - Fax:706-327-0757
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160794363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner