Healthcare Provider Details
I. General information
NPI: 1134887946
Provider Name (Legal Business Name): ALEXANDRA MICHAEL COWPER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2021
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5303 OLD SAN JOSE RD
SOQUEL CA
95073-9622
US
IV. Provider business mailing address
5303 OLD SAN JOSE RD
SOQUEL CA
95073-9622
US
V. Phone/Fax
- Phone: 216-780-1361
- Fax:
- Phone: 216-780-1361
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | CNM07339 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 236397 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: