Individual
JESSICA BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
26136 US HIGHWAY 59, FAIRFAX, MO 64446-9105
(660) 686-2211
Mailing address
9649 COUNTY ROAD 73, FILLMORE, MO 64449-9183
(816) 387-1519
(660) 686-2618
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2021046379
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
02/01/2022
Last updated
02/01/2022
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