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General NPI Number Information
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NPI Number | 1821694977
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Entity Type | Individual
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Provider Name | MATTHEW LEE MCCOWAN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 2923 E 29TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-4811
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Country | US
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Telephone | 888-227-3312
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Fax | 509-227-7070
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Provider Business Mailing Address
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Address Line | 5521 REDHAWK DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1234
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Country | US
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Telephone | 727-666-3235
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11010188
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License Number State | FL
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