Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9353231 | FL |
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9353231 | FL |
N | 363LA2100X | Nurse Practitioner - Acute Care | SP010441 | PA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN9353231 | FL |
NPI | 1356671044 |
---|---|
Provider Name | Ms. Holly R Bowyer |
First Address | Rockledge, FL 32955-4306 |
Second Address | Orlando, FL 32819-8001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2010 |
Last Update Date | 14/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008392900 | (05) | FL |
MK962 | MEDICARE (01) | FL |