Provider Demographics
NPI:1588486443
Name:COWDEN, GINA MARIE (RN, IBCLC, MBA)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:COWDEN
Suffix:
Gender:F
Credentials:RN, IBCLC, MBA
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:SALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18586 OLOV RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-7551
Mailing Address - Country:US
Mailing Address - Phone:209-743-8229
Mailing Address - Fax:
Practice Address - Street 1:211 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5025
Practice Address - Country:US
Practice Address - Phone:209-743-8229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-46581163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant