Provider Demographics
NPI:1689495590
Name:COMPASS HEALTH DIRECT PRIMARY CARE CORPORATION
Entity type:Organization
Organization Name:COMPASS HEALTH DIRECT PRIMARY CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSICH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:919-389-0900
Mailing Address - Street 1:6208 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713
Mailing Address - Country:US
Mailing Address - Phone:984-265-7334
Mailing Address - Fax:984-224-8726
Practice Address - Street 1:6208 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:984-265-7334
Practice Address - Fax:984-224-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty