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General NPI Number Information
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NPI Number | 1174022461
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Entity Type | Individual
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Provider Name | SARA COWAN CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 11908 DARNESTOWN RD STE H
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-990-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 911 MERRIDALE BLVD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-5263
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Country | US
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Telephone | 847-989-5524
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R214745
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License Number State | MD
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