Individual
JENNIFER BZOWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2460 NW STEWART PKWY, SUITE 240, ROSEBURG, OR 97471-1516
(541) 677-4427
(541) 677-6522
Mailing address
PO BOX 568, WINCHESTER, OR 97495-0568
(541) 677-4427
(541) 677-6522
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
201603200NPPP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500713156
—
OR
Enumeration date
09/15/2006
Last updated
04/03/2017
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