Provider Demographics
NPI:1447625322
Name:COWEN, ANN (MSN, RN, ANP, CDE)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:COWEN
Suffix:
Gender:F
Credentials:MSN, RN, ANP, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-1845
Mailing Address - Country:US
Mailing Address - Phone:704-660-5520
Mailing Address - Fax:704-799-1182
Practice Address - Street 1:548 WILLIAMSON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8194
Practice Address - Country:US
Practice Address - Phone:704-660-5520
Practice Address - Fax:704-799-1182
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015032910363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health