MEDICARE: DAWN MARIE BOWKER RN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	R1075911	MN

General Provider Information

NPI Number	:	1912980319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MARIE BOWKER RN, CNP

Provider Business Mailing Address
First Line	:	6545 FRANCE AVE S
Second Line	:	SUITE 600
City	:	EDINA
State	:	MN
Zip	:	55435-2131
Country	:	US
Telephone Number	:	952-920-2200
Fax Number	:	952-920-0866

Provider Business Practice Location Address
First Line	:	6545 FRANCE AVE S
Second Line	:	SUITE 600
City	:	EDINA
State	:	MN
Zip	:	55435-2131
Country	:	US
Telephone Number	:	952-920-2200
Fax Number	:	952-920-0866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/08/2007

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