Provider Demographics
NPI:1063180776
Name:COWAN, MELISSA ANN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:COWAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:SEIDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3625 N ANKENY BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4611
Mailing Address - Country:US
Mailing Address - Phone:515-965-4664
Mailing Address - Fax:
Practice Address - Street 1:6000 UNIVERSITY AVE STE 101
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8201
Practice Address - Country:US
Practice Address - Phone:515-241-2600
Practice Address - Fax:515-241-2032
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily