Individual
ANNA MAE COWGUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
(479) 344-6404
Mailing address
PO BOX 507, LOWELL, AR 72745-0507
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C02714
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174709001
—
AR
01
—
5V088
BCBSAR
AR
Enumeration date
06/02/2008
Last updated
06/29/2020
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