Individual
TERESA LOUISE COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 RIVERPLACE BLVD, SUITE 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Mailing address
1200 RIVERPLACE BLVD, SUITE 620, JACKSONVILLE, FL 32207-9046
(904) 396-6620
(904) 396-6528
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101425
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00003984
PRESCRIBING NUMBER STATE OF FLORIDA
FL
Enumeration date
06/07/2010
Last updated
06/26/2015
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