Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 3011P | KY |
NPI | 1093701013 |
---|---|
Provider Name | Jinna-Lee Bower |
First Address | Cadiz, KY 42211-6226 |
Second Address | Cadiz, KY 42211-6226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 08/07/2007 |