Marylou Cowles, APRN
Individual provider Active NPI Family Nurse Practitioner · Old Saybrook, CT
NPI 1093765786 · NPPES record last updated Apr 14, 2015
Key facts
- NPI
- 1093765786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 003031 (CT)
- Practice address
- 20 Research Pkwy
Old Saybrook, CT 06475-4214 - Phone
- (800) 370-3651
- Fax
- (860) 510-0020
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Specialist, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003031 | CT | MD | Nurse Practitioner |
| NP36913 | RI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medoptions Behavioral Health Assoc, LLC | Nurse Practitioner | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 003031 | CT | |
| Nurse Practitioner | 363L00000X | NP36913 | RI | |
| Family Nurse Practitioner | 363LF0000X | 003031 | CT | Yes |
Addresses
Primary practice location
20 Research Pkwy
Old Saybrook, CT 06475-4214
Mailing address
20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone (800) 370-3651
Other names
- Marylou Ritacco
Other providers in Old Saybrook, CT
- Connecticut CVS Pharmacy LLC
- Connecticut River Area Health District
- Lauren Connelly
- Ewa Conroy
- Susan E. Consoli
- Craig E McKnight MD PHD LLC
- Craig S. Wilson, D.D.S., LLC
- Laura Craven
- Nicole Chantel Crochetiere
- Christine R Crosson
All providers in Old Saybrook, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.