Individual
VANITA ANDREA BOWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 HARRISON AVE APT G7, PANAMA CITY, FL 32405-4564
(850) 688-5244
Mailing address
2121 HARRISON AVE APT G7, PANAMA CITY, FL 32405-4564
(850) 688-5244
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
234759
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020363100
—
FL
05
—
022663400
—
FL
Enumeration date
01/02/2018
Last updated
01/02/2018
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