Provider Demographics
NPI:1366294944
Name:COSPER, COURTNEY R
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:R
Last Name:COSPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NE 162ND PL
Mailing Address - Street 2:
Mailing Address - City:CITRA
Mailing Address - State:FL
Mailing Address - Zip Code:32113-3106
Mailing Address - Country:US
Mailing Address - Phone:352-789-0562
Mailing Address - Fax:
Practice Address - Street 1:1700 NE 162ND PL
Practice Address - Street 2:
Practice Address - City:CITRA
Practice Address - State:FL
Practice Address - Zip Code:32113-3106
Practice Address - Country:US
Practice Address - Phone:352-789-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula