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General NPI Number Information
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NPI Number | 1720473325
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Entity Type | Individual
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Provider Name | VICKY BOWSER APN
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Gender | Female
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 621 BEVERLY RANCOCAS RD SUITE 2D
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City | WILLINGBORO
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State | NJ
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Zip | 08046-3727
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Country | US
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Telephone | 609-877-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 DAVISTOWN RD
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City | BLACKWOOD
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State | NJ
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Zip | 08012-3332
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Country | US
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Telephone | 856-357-0231
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NJ00537000
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License Number State | NJ
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