Provider Demographics
NPI:1295483022
Name:COWAN, SHERIKA
Entity type:Individual
Prefix:
First Name:SHERIKA
Middle Name:
Last Name:COWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 FARMLAND WAY
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-2510
Mailing Address - Country:US
Mailing Address - Phone:901-687-1877
Mailing Address - Fax:
Practice Address - Street 1:951 COURT
Practice Address - Street 2:AVE
Practice Address - City:MEMPHIS
Practice Address - State:TENNESSEE
Practice Address - Zip Code:38103
Practice Address - Country:UM
Practice Address - Phone:901-577-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health