Provider Demographics
NPI:1023079084
Name:COWELL, GINGER LYNNE (NP)
Entity type:Individual
Prefix:MS
First Name:GINGER
Middle Name:LYNNE
Last Name:COWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34693
Mailing Address - Street 2:BAYFRONT EMERGENCY PHYSICIANS PA
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07189-4963
Mailing Address - Country:US
Mailing Address - Phone:610-668-6471
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:501 W 14TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-320-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019500363L00000X
DELG-0000944363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0088579Medicaid
NJ089860Medicare ID - Type Unspecified
NJ0088579Medicaid