Provider Demographics
NPI:1497357636
Name:COWLES, ALICIA NICOLE
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:NICOLE
Last Name:COWLES
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 1:2944 COUNTY ROAD 186
Mailing Address - Street 2:
Mailing Address - City:CARDINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43315-9344
Mailing Address - Country:US
Mailing Address - Phone:419-560-8657
Mailing Address - Fax:
Practice Address - Street 1:2944 COUNTY ROAD 186
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9344
Practice Address - Country:US
Practice Address - Phone:419-560-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker