Provider Demographics
NPI:1619855889
Name:COWAN, ROSETTA RENAE (BSN RN)
Entity type:Individual
Prefix:MS
First Name:ROSETTA
Middle Name:RENAE
Last Name:COWAN
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2409
Mailing Address - Country:US
Mailing Address - Phone:330-953-0766
Mailing Address - Fax:330-953-1531
Practice Address - Street 1:1632 FERNDALE AVE SW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-3949
Practice Address - Country:US
Practice Address - Phone:330-883-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN294207163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty