Healthcare Provider Details

I. General information

NPI: 1255502134
Provider Name (Legal Business Name): JULIE ANN COWLES PNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

2640 HOLMAN CT
COLORADO SPRINGS CO
80919-3827
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-2919
  • Fax:
Mailing address:
  • Phone: 719-535-8136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number173873
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: