Healthcare Provider Details

I. General information

NPI: 1174022461
Provider Name (Legal Business Name): SARA COWAN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA DRURY CPNP

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11717 OLD NATIONAL PIKE
NEW MARKET MD
21774-6154
US

IV. Provider business mailing address

11717 OLD NATIONAL PIKE STE 8
NEW MARKET MD
21774-6119
US

V. Phone/Fax

Practice location:
  • Phone: 301-882-7489
  • Fax:
Mailing address:
  • Phone: 301-882-7489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR214745
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: