Provider Demographics
NPI:1609116854
Name:COSGROVE, ALI BOYCE (NP-C, CRNA)
Entity Type:Individual
Prefix:MISS
First Name:ALI
Middle Name:BOYCE
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:NP-C, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:ADVANCED CARDIAC CARE CLINIC & MISSION
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-0152
Practice Address - Fax:828-213-7053
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225635363L00000X
NC5006083363LA2200X
NC6698367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health