Individual
MISS JENNIFER COGDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1028 LEE ANN DR NE STE 200, CONCORD, NC 28025-2915
(704) 792-9173
Mailing address
1028 LEE ANN DR NE STE 200, CONCORD, NC 28025-2915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03930
NC
363AM0700X
Medical Physician Assistant
C0004668
MD
Other
Enumeration date
05/08/2012
Last updated
10/26/2020
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