Individual
MR. JASON RANDEL BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1827C SIMPSON HIGHWAY 149, MENDENHALL, MS 39114-3439
(601) 847-2224
(601) 847-2199
Mailing address
PO BOX 333, HARRISVILLE, MS 39082-0333
(601) 847-2224
(601) 847-2199
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R861662
MS
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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