Organization
COWAN GERIATRIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANESHA M COWAN FNP (OWNER)
(901) 289-0564
Entity
Organization
Contact information
Practice address
10377 TRAIL HILL LN, CORDOVA, TN 38016-6670
(901) 289-0564
Mailing address
PO BOX 41784, MEMPHIS, TN 38174-1784
(901) 289-0564
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
RN147062
TN
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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