Individual
WILL COWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514
(574) 294-2621
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-2483
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28281333A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300078977
—
IN
Enumeration date
07/06/2020
Last updated
08/29/2023
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