Healthcare Provider Details
I. General information
NPI: 1174934368
Provider Name (Legal Business Name): ASHLEY MARIE COWAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/10/2014
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13123 E 16TH AVE
AURORA CO
80045-7106
US
IV. Provider business mailing address
1189 WAIMANU ST APT 3309
HONOLULU HI
96814-4184
US
V. Phone/Fax
- Phone: 720-777-2715
- Fax:
- Phone: 210-887-9127
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | DR.0070816 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD19234 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: