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General NPI Number Information
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NPI Number | 1902468457
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Entity Type | Individual
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Provider Name | SHIRLEY RYAN KOSS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 463 WORCESTER RD STE 104
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5354
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Country | US
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Telephone | 508-650-0010
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Fax | 508-653-3916
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Provider Business Mailing Address
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Address Line | 171 MAIN ST STE 203B
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City | ASHLAND
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State | MA
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Zip | 01721-1187
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Country | US
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Telephone | 508-881-3029
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Fax | 508-881-1752
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2301202
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License Number State | MA
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