Healthcare Provider Details

I. General information

NPI: 1902714207
Provider Name (Legal Business Name): BOBBIE JO MCDOWELL L.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 COMMERCE DR STE 208
WESTOVER WV
26501-3858
US

IV. Provider business mailing address

10222 PROCTOR CREEK RD
NEW MARTINSVILLE WV
26155-8659
US

V. Phone/Fax

Practice location:
  • Phone: 304-285-5500
  • Fax: 304-285-2787
Mailing address:
  • Phone: 740-415-5096
  • Fax: 304-285-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number32632
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: