Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | PA9105122 | FL |
NPI | 1942592191 |
---|---|
Provider Name | Maggie Bowers |
First Address | Jacksonville, FL 32202-2847 |
Second Address | Jacksonville, FL 32202-2847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 06/05/2011 |