Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN11001713 | FL |
NPI | 1023668837 |
---|---|
Provider Name | Mrs. Jenny Lynn Bowles |
First Address | Orlando, FL 32886-3407 |
Second Address | Sarasota, FL 34239-3605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2019 |
Last Update Date | 22/10/2019 |