Provider Demographics
NPI:1154891679
Name:COWART, FAITH URSULA (LPN)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:URSULA
Last Name:COWART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 TRADEWINDS DR APT G
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2454
Mailing Address - Country:US
Mailing Address - Phone:910-973-1234
Mailing Address - Fax:
Practice Address - Street 1:415 TRADEWINDS DR APT G
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2454
Practice Address - Country:US
Practice Address - Phone:919-910-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC69899164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse