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NPI Code Detail

MEDICARE: RENEE ANN BOWZER RN

MEDICARE:   RENEE ANN BOWZER  RN
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
1163W00000XRegistered NurseRN00074570WA

General Provider Information

NPI Number : 1528310059
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE ANN BOWZER RN
Provider Business Mailing Address
First Line : 31503 W LAKE KETCHUM RD
Second Line :
City : STANWOOD
State : WA
Zip : 98292-9710
Country : US
Telephone Number : 360-629-4349
Fax Number :
Provider Business Practice Location Address
First Line : 31503 W LAKE KETCHUM RD
Second Line :
City : STANWOOD
State : WA
Zip : 98292-9710
Country : US
Telephone Number : 360-629-4349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2012
Last Update Date : 10/08/2012

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Directions to “ RENEE ANN BOWZER RN” Practice Location

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