Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 209-006714 | IL |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 209006714041325322 | IL |
NPI | 1023346582 |
---|---|
Provider Name | Mrs. Laura K Bowers |
First Address | Springfield, IL 62702-5131 |
Second Address | Springfield, IL 62702-5303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2009 |
Last Update Date | 15/03/2021 |