Provider Demographics
NPI:1891869145
Name:COWAN, BRENDA MARIE (DNP APNP CPNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:MARIE
Last Name:COWAN
Suffix:
Gender:F
Credentials:DNP APNP CPNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:M
Other - Last Name:COWAN FRAUTSCHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP CPNP
Mailing Address - Street 1:2108 E THOMAS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0008
Mailing Address - Country:US
Mailing Address - Phone:602-933-1813
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126473363LP0200X
NE113733363LP0200X
AZ276918363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP126473OtherAPNP
TX862939OtherRN
WI3067-033OtherAPNP