Provider Demographics
NPI:1679313050
Name:COWDIN, JESSICA LEIGHANNA MARIE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGHANNA MARIE
Last Name:COWDIN
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 1:2009 GREENE GABLES CT
Mailing Address - Street 2:
Mailing Address - City:RIDGELEY
Mailing Address - State:WV
Mailing Address - Zip Code:26753-7394
Mailing Address - Country:US
Mailing Address - Phone:540-684-8445
Mailing Address - Fax:
Practice Address - Street 1:2009 GREENE GABLES CT
Practice Address - Street 2:
Practice Address - City:RIDGELEY
Practice Address - State:WV
Practice Address - Zip Code:26753-7394
Practice Address - Country:US
Practice Address - Phone:540-684-8445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant