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Individual

MR. JIMMY WAYNE BOWLIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
760 CHESTNUT ST, GADSDEN, AL 35901-4147
(256) 543-1100
(256) 543-1101
Mailing address
137 HICKORY RIDGE DR, GLENCOE, AL 35905-9603
(256) 442-5937

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-056721
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51530773
PROVIDER
AL
Enumeration date
10/03/2006
Last updated
07/09/2007
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