Provider Demographics
NPI:1396743456
Name:COWAN, CHERRY ANN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:ANN
Last Name:COWAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 DUMBARTON ST
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4206
Mailing Address - Country:US
Mailing Address - Phone:703-981-5545
Mailing Address - Fax:
Practice Address - Street 1:1742 DUMBARTON ST
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4206
Practice Address - Country:US
Practice Address - Phone:703-981-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN66686367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P27663Medicare UPIN