Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.020662 | OH |
NPI | 1003341074 |
---|---|
Provider Name | Amanda Mowrer |
First Address | Sagamore Hills, OH 44067-1046 |
Second Address | Warrensville Heights, OH 44122-6805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2017 |
Last Update Date | 20/06/2017 |