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General NPI Number Information
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NPI Number | 1003230848
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Entity Type | Individual
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Provider Name | KIRSTIEMA ANN COWAN DNP
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Gender | Female
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 05/08/2022
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Provider Practice Location Address
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Address Line | 30 WARBLER WAY
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City | HAMPSTEAD
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State | NC
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Zip | 28443-8238
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Country | US
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Telephone | 360-528-1259
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Fax |
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Provider Business Mailing Address
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Address Line | 30 WARBLER WAY
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City | HAMPSTEAD
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State | NC
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Zip | 28443-8238
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95000199
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5015761
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License Number State | NC
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