Provider Demographics
NPI:1376671321
Name:COWAN, MARCIA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:K
Last Name:COWAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-1327
Mailing Address - Country:US
Mailing Address - Phone:931-455-2674
Mailing Address - Fax:931-455-7594
Practice Address - Street 1:1330 CEDAR LN BLDG B
Practice Address - Street 2:SUITE 900
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2283
Practice Address - Country:US
Practice Address - Phone:931-455-2674
Practice Address - Fax:931-455-7594
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32563363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics