Provider Demographics
NPI:1700381332
Name:COWAN, JULIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:COWAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27820 FERN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-9559
Mailing Address - Country:US
Mailing Address - Phone:541-367-7342
Mailing Address - Fax:
Practice Address - Street 1:759 27TH AVE
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-2994
Practice Address - Country:US
Practice Address - Phone:541-409-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR085068216RN364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care