Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9393690 | FL |
NPI | 1003341595 |
---|---|
Provider Name | Sarah Bowermaster |
First Address | Bradenton, FL 34202-9420 |
Second Address | St Petersburg, FL 33709-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2017 |
Last Update Date | 22/04/2017 |