Individual
JACQUELINE M COWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1911 S 17TH ST, SUITE 130A, WILMINGTON, NC 28401-6663
(910) 790-7840
Mailing address
1911 S 17TH ST, SUITE 130A, WILMINGTON, NC 28401-6663
(910) 790-7840
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-03273
NC
Other
Enumeration date
02/15/2012
Last updated
12/27/2013
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