=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598474942
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIE GLEE MOWRY APNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2022
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 NYGAARD ST
-----------------------------------------------------
City | STOUGHTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53589-5495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-877-2660
-----------------------------------------------------
Fax | 608-877-2667
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7974 UW HEALTH CT
-----------------------------------------------------
City | MIDDLETON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53562-5531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 13399
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 13399
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------