Provider Demographics
NPI:1043911779
Name:COWIE, CECILIE (NP)
Entity Type:Individual
Prefix:
First Name:CECILIE
Middle Name:
Last Name:COWIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6613
Mailing Address - Country:US
Mailing Address - Phone:229-226-0125
Mailing Address - Fax:229-226-0195
Practice Address - Street 1:900 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6613
Practice Address - Country:US
Practice Address - Phone:229-226-0125
Practice Address - Fax:229-226-0195
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN226187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily