Provider Demographics
NPI:1730247917
Name:COWEE, MICHELE ANN (RD CDE)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANN
Last Name:COWEE
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4152
Mailing Address - Country:US
Mailing Address - Phone:775-884-0544
Mailing Address - Fax:775-884-2410
Practice Address - Street 1:302 N MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4152
Practice Address - Country:US
Practice Address - Phone:775-884-0544
Practice Address - Fax:775-884-2410
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
871181133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV38798Medicare ID - Type Unspecified