Individual
ASHLEY TANELL COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6128 E 38TH ST, TULSA, OK 74135-5832
(918) 557-2526
Mailing address
6111 E SKELLY DR, TULSA, OK 74135-6100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
219368
OK
Other
Enumeration date
09/11/2024
Last updated
09/23/2024
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