Provider Demographics
NPI:1164177820
Name:COWAN, KATHRYN TAYLOR
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TAYLOR
Last Name:COWAN
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:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5698
Mailing Address - Fax:
Practice Address - Street 1:207 LINDA VISTA DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2743
Practice Address - Country:US
Practice Address - Phone:828-693-9632
Practice Address - Fax:828-693-6244
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily