Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 5116 | MN |
N | 363L00000X | Nurse Practitioner | R-188192-7 | MN |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 5116 | MN |
NPI | 1003351602 |
---|---|
Provider Name | Natalie Cowell |
First Address | St Louis Park, MN 55426-2505 |
Second Address | St Louis Park, MN 55426-2505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2017 |
Last Update Date | 05/01/2022 |