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NPI Code Detail

MEDICARE: MARISA BOWERS FNP-C

MEDICARE: MARISA BOWERS FNP-C
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
1363LP2300XPrimary Care Nurse Practitioner2021040196MO

General Provider Information

NPI Number : 1487308235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISA BOWERS FNP-C
Provider Business Mailing Address
First Line : 412 NW EASTWOOD DR
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-1634
Country : US
Telephone Number : 816-536-4703
Fax Number :
Provider Business Practice Location Address
First Line : 7755 CENTER AVE STE 630
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-9152
Country : US
Telephone Number : 265-237-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2022
Last Update Date : 02/12/2022

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