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General NPI Number Information
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NPI Number | 1316928153
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Entity Type | Individual
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Provider Name | MARY CATHERINE NOWLIN DO
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 7155 W CAMPO BELLO DR STE C120
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City | GLENDALE
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State | AZ
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Zip | 85308-8594
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Country | US
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Telephone | 623-322-7301
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Fax | 623-337-9562
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Provider Business Mailing Address
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Address Line | 7155 W CAMPO BELLO DR STE C120
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City | GLENDALE
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State | AZ
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Zip | 85308-8594
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Country | US
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Telephone | 623-322-7301
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Fax | 623-337-9562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 3514
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License Number State | AZ
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