Provider Demographics
NPI:1356638290
Name:COWARD, KIRK A (APN)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:A
Last Name:COWARD
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 W. KINGSHIGHWAY
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4038
Mailing Address - Country:US
Mailing Address - Phone:870-236-6930
Mailing Address - Fax:870-239-8065
Practice Address - Street 1:1000 W KINGSHIGHWAY
Practice Address - Street 2:SUITE 12
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4141
Practice Address - Country:US
Practice Address - Phone:870-236-6930
Practice Address - Fax:870-239-8065
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA03564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily