Basic Information
| Provider Information | |||||||||
| NPI: | 1295483022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COWAN | ||||||||
| FirstName: | SHERIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5011 FARMLAND WAY | ||||||||
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| City: | BARTLETT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380022510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016871877 | ||||||||
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| Practice Location | |||||||||
| Address1: | 951 COURT | ||||||||
| Address2: | AVE | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TENNESSEE | ||||||||
| PostalCode: | 38103 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 9015779400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2022 | ||||||||
| LastUpdateDate: | 03/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 31096 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.