| Doctor Name: | TERESA LOUISE COWAN |
| NPI Number: | 1003136516 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA9101425 |
| Business Practice Address: | 1200 Riverplace Blvd Suite 620 Jacksonville, FL - 322079046 |
| Business Phone Number: | 9043966620 |
| Business Fax Number: | 9043966528 |
| Mailing Address: | 1200 Riverplace Blvd, Suite 620 JACKSONVILLE |
| State: | FL |
| Postal Code: | 322079046 |
| Phone Number: | 9043966620 |
| Fax Number: | 9043966528 |
| NPI Enumeration Date: | 06/07/2010 |
| NPI Last Update Date: | 06/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9101425 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |