Provider Demographics
NPI:1124497573
Name:COWEN, KYLA CHRISTIN JO (APRN)
Entity type:Individual
Prefix:MRS
First Name:KYLA
Middle Name:CHRISTIN JO
Last Name:COWEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KYLA
Other - Middle Name:CHRISTIN JO
Other - Last Name:WITTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3460 E FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006
Mailing Address - Country:US
Mailing Address - Phone:918-332-3600
Mailing Address - Fax:918-332-3613
Practice Address - Street 1:3460 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2406
Practice Address - Country:US
Practice Address - Phone:918-332-3600
Practice Address - Fax:918-332-3613
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily