MEDICARE: GARY SOWINSKI 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	363LF0000X	Family Nurse Practitioner	F0612591	OH

General Provider Information

NPI Number	:	1992228258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY SOWINSKI NP

Provider Business Mailing Address
First Line	:	140 SPRINGCOVE LN
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-8056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6819 SPRING VALLEY DR
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9487
Country	:	US
Telephone Number	:	419-930-5700
Fax Number	:

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

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	06/15/2022

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