Healthcare Provider Details

I. General information

NPI: 1326955790
Provider Name (Legal Business Name): KEVYANN COWLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7103 ROBIN DR UNIT 2
GILLETTE WY
82718-7045
US

IV. Provider business mailing address

7103 ROBIN DR UNIT 2
GILLETTE WY
82718-7045
US

V. Phone/Fax

Practice location:
  • Phone: 307-622-3032
  • Fax:
Mailing address:
  • Phone: 307-622-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: