Individual
MRS. LEATRICE R COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 624-3534
(662) 621-5087
Mailing address
1760 BENNING ST, MEMPHIS, TN 38106-6231
(901) 948-1033
(662) 621-5087
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
A810086
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05287878
—
MS
Enumeration date
05/20/2006
Last updated
06/27/2013
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