1184681694 NPI number — MS. JANET SUE PASQUALI BOWERS APRN, CNP

Table of content: MS. JANET SUE PASQUALI BOWERS APRN, CNP (NPI 1184681694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184681694 NPI number — MS. JANET SUE PASQUALI BOWERS APRN, CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWERS
Provider First Name:
JANET
Provider Middle Name:
SUE PASQUALI
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EPLEY
Provider Other First Name:
JANET
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184681694
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7800 NW 85TH TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73132-3385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3306 N KICKAPOO AVE
Provider Second Line Business Practice Location Address:
SUITE 150 & 154
Provider Business Practice Location Address City Name:
SHAWNEE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74804-1702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-628-6535
Provider Business Practice Location Address Fax Number:
405-628-6532
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  R0047718 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 47718 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100101530B , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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