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Individual

CHARLOTTE M COWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.A.

Contact information

Practice address
800 W JEFFERSON ST, NORTHEAST REGIONAL MEDICAL CENTER, KIRKSVILLE, MO 63501-1443
(660) 785-1000
(660) 785-1237
Mailing address
PO BOX 702, KIRKSVILLE, MO 63501-0702
(660) 785-1000
(660) 785-1237

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
121063
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0976845
IA
01
80177
HEALTHCARE USA
MO
01
8298
HEALTHCARE USA (GROUP)
MO
05
918400904
MO
01
CG4336
RAILROAD MEDICARE
01
P00130500
RAILROAD MEDICARE
Enumeration date
02/28/2007
Last updated
08/21/2008
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