Provider Demographics
NPI:1679943815
Name:TAYLOR-COWAN, TIANA (LPN)
Entity Type:Individual
Prefix:
First Name:TIANA
Middle Name:
Last Name:TAYLOR-COWAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 SCHOOLHOUSE RD
Mailing Address - Street 2:APT A
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5957
Mailing Address - Country:US
Mailing Address - Phone:518-221-9556
Mailing Address - Fax:
Practice Address - Street 1:249 SCHOOLHOUSE RD
Practice Address - Street 2:APT A
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5957
Practice Address - Country:US
Practice Address - Phone:518-221-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321013164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse