Provider Demographics
NPI:1508634502
Name:COWER, SUSAN S (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:COWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MIMOSA LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38572-5578
Mailing Address - Country:US
Mailing Address - Phone:193-200-4025
Mailing Address - Fax:
Practice Address - Street 1:210 MIMOSA LN
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38572-5578
Practice Address - Country:US
Practice Address - Phone:193-124-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN131141163WU0100X
TN131041163WU0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WU0100XNursing Service ProvidersRegistered NurseUrologyGroup - Single Specialty