Provider Demographics
NPI:1982983334
Name:COGSWELL, COURTNEY (FNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:COGSWELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RESERVOIR ST
Mailing Address - Street 2:#25
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3149
Mailing Address - Country:US
Mailing Address - Phone:781-449-8900
Mailing Address - Fax:781-449-8911
Practice Address - Street 1:220 RESERVOIR ST
Practice Address - Street 2:#25
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3149
Practice Address - Country:US
Practice Address - Phone:781-449-8900
Practice Address - Fax:781-449-8911
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily