Healthcare Provider Details

I. General information

NPI: 1598273377
Provider Name (Legal Business Name): KALEIGH S COWART NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 HEMLOCK ST STE 200
MACON GA
31201-4200
US

IV. Provider business mailing address

458 HEMLOCK ST STE 200
MACON GA
31201-4200
US

V. Phone/Fax

Practice location:
  • Phone: 478-744-2445
  • Fax: 478-744-0906
Mailing address:
  • Phone: 478-744-2445
  • Fax: 478-744-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN210578
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number049978GA
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: