Provider Demographics
NPI:1184903023
Name:COWARD, LATOYA JEAN (APN)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:JEAN
Last Name:COWARD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 CARRIAGE HILL DR STE B
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5329
Mailing Address - Country:US
Mailing Address - Phone:870-573-2200
Mailing Address - Fax:870-573-2300
Practice Address - Street 1:3501 CARRIAGE HILL DR STE B
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5329
Practice Address - Country:US
Practice Address - Phone:870-573-2200
Practice Address - Fax:870-573-2300
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR194728758Medicaid
MO2011029158OtherMISSOURI STATE BOARD OF NURSING
ARA03586OtherARKANSAS STATE BOARD OF NURSING APN
ARA03586OtherARKANSAS STATE BOARD OF NURSING APN
AR57974Medicare UPIN