Basic Information
| Provider Information | |||||||||
| NPI: | 1962423533 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MC COWAN | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN, GNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PATTERSON | ||||||||
| OtherFirstName: | LESLIE | ||||||||
| OtherMiddleName: | A | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | RN, GNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11700 W 2ND PL | ||||||||
| Address2: | MEDICAL PLAZA II, SUITE 4-450 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038251234 | ||||||||
| FaxNumber: | 7203218121 | ||||||||
| Practice Location | |||||||||
| Address1: | 11700 W 2ND PL | ||||||||
| Address2: | MEDICAL PLAZA II, SUITE 4-450 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038251234 | ||||||||
| FaxNumber: | 7203218121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 02/22/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 71309 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.