Individual
STACY LYNN COWHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5550 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6426
(317) 352-9157
(317) 359-4052
Mailing address
1720 N BOLTON AVE, INDIANAPOLIS, IN 46218-5133
(317) 625-4023
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27059681A
IN
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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