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General NPI Number Information
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NPI Number | 1487308235
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Entity Type | Individual
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Provider Name | MARISA BOWERS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/12/2022
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Provider Practice Location Address
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Address Line | 7755 CENTER AVE STE 630
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-9152
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Country | US
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Telephone | 265-237-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 412 NW EASTWOOD DR
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City | BLUE SPRINGS
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State | MO
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Zip | 64014-1634
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Country | US
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Telephone | 816-536-4703
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 2021040196
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License Number State | MO
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