MEDICARE: MRS. JUANITA CLOWERS NP

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	363LP0200X	Pediatric Nurse Practitioner	71005290A	IN

General Provider Information

NPI Number	:	1609264456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUANITA CLOWERS NP

Provider Business Mailing Address
First Line	:	1503 N MITTHOEFER RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2425
Country	:	US
Telephone Number	:	317-934-0750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 N ARLINGTON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-3204
Country	:	US
Telephone Number	:	317-762-0190
Fax Number	:	317-357-1890

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

Provider Enumeration Date	:	01/02/2015
Last Update Date	:	10/13/2025

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