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General NPI Number Information
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NPI Number | 1477153211
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Entity Type | Individual
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Provider Name | JOAN MARIE BOWEN
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Gender | Female
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 3201 W BROADWAY BLVD
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City | SEDALIA
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State | MO
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Zip | 65301-2118
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Country | US
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Telephone | 660-826-2144
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Fax |
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Provider Business Mailing Address
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Address Line | 21916 HIGHWAY F
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City | SEDALIA
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State | MO
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Zip | 65301-0775
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Country | US
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Telephone | 660-553-1674
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10386
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2009014961
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License Number State | MO
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