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NPI Code Detail

MEDICARE: MRS. LISA M COGSWELL NP

MEDICARE: MRS. LISA M COGSWELL NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner4704243632MI

General Provider Information

NPI Number : 1366698789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA M COGSWELL NP
Provider Business Mailing Address
First Line : 2200 GREEN RD
Second Line : SUITE B
City : ANN ARBOR
State : MI
Zip : 48105-2948
Country : US
Telephone Number : 734-994-7446
Fax Number : 734-623-8590
Provider Business Practice Location Address
First Line : 2200 GREEN RD
Second Line : SUITE B
City : ANN ARBOR
State : MI
Zip : 48105-2948
Country : US
Telephone Number : 734-994-7446
Fax Number : 734-623-8590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2008
Last Update Date : 06/08/2026

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