Individual
KIMBERLY LYNN COWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2855 OLD HIGHWAY 5, BLUE RIDGE, GA 30513-6248
(706) 632-3711
Mailing address
311 WINTER DR, MORGANTON, GA 30560-8210
(706) 374-0408
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
237082
GA
367500000X
Certified Registered Nurse Anesthetist
9189783
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021437602
MEDICARE ID - UNION GENERAL HOSPITAL
GA
01
—
202I432222
MEDICARE ID- GEORGIA ANESTHESIA PARTNERS, LLC
GA
01
—
202I436726
MEDICARE ID- AHP OF CENTRAL GEORGIA, PC
GA
Enumeration date
01/08/2010
Last updated
03/11/2015
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