Healthcare Provider Details

I. General information

NPI: 1326768508
Provider Name (Legal Business Name): PRIMROSE WOMENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 E STROOP RD
KETTERING OH
45429-3245
US

IV. Provider business mailing address

529 E STROOP RD
KETTERING OH
45429-3245
US

V. Phone/Fax

Practice location:
  • Phone: 937-689-3769
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARRIE ANN COGLEY
Title or Position: APRN/OWNER
Credential: APRN
Phone: --