Provider Demographics
NPI:1467442756
Name:COWART, LINDA R (CNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:R
Last Name:COWART
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2559
Mailing Address - Country:US
Mailing Address - Phone:678-567-8000
Mailing Address - Fax:770-439-3555
Practice Address - Street 1:4250 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2559
Practice Address - Country:US
Practice Address - Phone:678-567-8000
Practice Address - Fax:770-439-3555
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN051252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner