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General NPI Number Information
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NPI Number | 1487696084
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Entity Type | Organization
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Legal Business Name | COGENT HEALTHCARE OF WISCONSIN, SC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2900 W OKLAHOMA AVE SUITE D2121
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City | MILWAUKEE
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State | WI
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Zip | 53215-4330
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Country | US
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Telephone | 414-385-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BRENTWOOD COMMONS WAY STE 510
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City | BRENTWOOD
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State | TN
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Zip | 37027-2028
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Country | US
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Telephone | 253-682-6040
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LAURA FALL
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Credential |
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Telephone | 253-682-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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