Provider Demographics
NPI:1811625064
Name:COWAN, SHAWANDA L (RN)
Entity type:Individual
Prefix:
First Name:SHAWANDA
Middle Name:L
Last Name:COWAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60461
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-6461
Mailing Address - Country:US
Mailing Address - Phone:239-295-1233
Mailing Address - Fax:
Practice Address - Street 1:12557 NEW BRITTANY BLVD STE 3V-5
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3651
Practice Address - Country:US
Practice Address - Phone:239-295-1233
Practice Address - Fax:239-722-4439
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9347082163WC2100X, 163WE0900X, 163WC1500X, 163WP0000X, 163WP0809X, 163WR0400X, 163WW0000X, 163WG0000X, 163WN1003X, 163WH1000X, 163WI0500X, 163WI0600X, 163WX1500X, 163WH0200X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management