Provider Demographics
NPI:1104651546
Name:COWDRY, JENNIFER ANN (RN,BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:COWDRY
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4376 DOERR RD
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-1305
Mailing Address - Country:US
Mailing Address - Phone:989-325-0853
Mailing Address - Fax:
Practice Address - Street 1:1332 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9288
Practice Address - Country:US
Practice Address - Phone:989-673-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704286318163WG0000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice