Basic Information
Provider Information
NPI: 1649570938
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COWDEN
FirstName: EMILY
MiddleName: ELDER
NamePrefix: MS.
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6715 GRANADA LN
Address2:  
City: PRAIRIE VILLAGE
State: KS
PostalCode: 662081632
CountryCode: US
TelephoneNumber: 9139044007
FaxNumber:  
Practice Location
Address1: 2401 GILLHAM RD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641084619
CountryCode: US
TelephoneNumber: 8162343000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2010
LastUpdateDate: 11/02/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X2010030427MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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