Provider Demographics
NPI:1902678634
Name:COWAN, NAKEISHA DENIQUE
Entity type:Individual
Prefix:
First Name:NAKEISHA
Middle Name:DENIQUE
Last Name:COWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N FRONT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:STEELTON
Mailing Address - State:PA
Mailing Address - Zip Code:17113-2367
Mailing Address - Country:US
Mailing Address - Phone:717-300-9393
Mailing Address - Fax:
Practice Address - Street 1:1135 OLDE W CHOCOLATE AVE
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9188
Practice Address - Country:US
Practice Address - Phone:717-832-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide