MEDICARE: MRS. JAMI L DOWELL FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	28170197A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71006669A	OTHER	IN	INDIANA LICENSE

General Provider Information

NPI Number	:	1417407024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAMI L DOWELL FNP

Provider Business Mailing Address
First Line	:	PO BOX 230
Second Line	:
City	:	SULLIVAN
State	:	IN
Zip	:	47882-0230
Country	:	US
Telephone Number	:	812-268-3318
Fax Number	:

Provider Business Practice Location Address
First Line	:	1602 N. UPPER 11 STREET
Second Line	:
City	:	VINCENNES
State	:	IN
Zip	:	47591-4820
Country	:	US
Telephone Number	:	812-886-4557
Fax Number	:	812-886-6347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	10/31/2016

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