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General NPI Number Information
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NPI Number | 1487789152
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Entity Type | Organization
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Legal Business Name | A WOMANS LIFE FAMILY HEALTH CARE CENTER LLC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 1435 N MOUNT AUBURN RD SUITE 200
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-2171
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Country | US
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Telephone | 573-334-7006
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Fax | 573-334-7090
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Provider Business Mailing Address
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Address Line | 1435 N MOUNT AUBURN RD SUITE 200
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-2171
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Country | US
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Telephone | 573-334-7006
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Fax | 573-334-7090
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Authorized Official
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Title or Position | OWNER
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Name | DOLORES J MCDOWELL
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Credential | APRN
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Telephone | 573-334-7006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 126562
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 119283
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License Number State | MO
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