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General NPI Number Information
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NPI Number | 1912170127
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Entity Type | Individual
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Provider Name | CELENA COWEN
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Gender | Female
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 36475 FIVE MILE RD PRE-ANESTHESIA TESTING
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City | LIVONIA
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State | MI
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Zip | 48154-1971
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Country | US
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Telephone | 734-655-2119
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Fax | 734-655-2942
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Provider Business Mailing Address
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Address Line | 36475 FIVE MILE RD PRE-ANESTHESIA TESTING
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City | LIVONIA
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State | MI
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Zip | 48154
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Country | US
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Telephone | 248-761-7943
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704220707
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License Number State | MI
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