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General NPI Number Information
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NPI Number | 1255770756
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Entity Type | Organization
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Legal Business Name | JANET R BOWEN, LLC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 1106 4TH AVE
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City | WOODRUFF
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State | WI
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Zip | 54568-9481
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Country | US
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Telephone | 715-358-7727
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Fax | 715-358-7525
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Provider Business Mailing Address
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Address Line | PO BOX 754
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City | WOODRUFF
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State | WI
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Zip | 54568-0754
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Country | US
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Telephone | 715-358-7727
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Fax | 715-358-7525
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JANET R BOWEN
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Credential | APNP
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Telephone | 715-358-7727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 57301-030
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License Number State | WI
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