MEDICARE: RACHEL RENEE COWAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN788155	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN788155	OTHER	PA	PA RN LICENSE

General Provider Information

NPI Number	:	1447069356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL RENEE COWAN

Provider Business Mailing Address
First Line	:	109 UNIVERSITY SQ
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16541-0002
Country	:	US
Telephone Number	:	724-456-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 STATE ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16541-0001
Country	:	US
Telephone Number	:	724-456-4619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	01/06/2025

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Directions to “ RACHEL RENEE COWAN ” Practice Location

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