MEDICARE: JENNIFER CHRISTINE BOWLING

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	APN0000017276	TN

General Provider Information

NPI Number	:	1972841534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CHRISTINE BOWLING

Provider Business Mailing Address
First Line	:	528 N UNIVERSITY ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-3012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	528 N UNIVERSITY ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-3012
Country	:	US
Telephone Number	:	615-867-3780
Fax Number	:

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

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	01/16/2013

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