Healthcare Provider Details

I. General information

NPI: 1336919547
Provider Name (Legal Business Name): JOHANNA JOY BOWSER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOHANNA JOY FLORENCE CPM

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 COUNTY ROAD 214
DURANGO CO
81303-6818
US

IV. Provider business mailing address

1157 COUNTY ROAD 214
DURANGO CO
81303-6818
US

V. Phone/Fax

Practice location:
  • Phone: 719-453-2447
  • Fax:
Mailing address:
  • Phone: 719-453-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMWR.0000254
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: