Doctor Name: | JOHN MARK BLOWEN |
NPI Number: | 1063494672 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 0297872303 |
Business Practice Address: | 3 Mark Ave Stratham, NH - 038852221 |
Business Phone Number: | 6038520513 |
Business Fax Number: | |
Mailing Address: | 3 Mark Ave, STRATHAM |
State: | NH |
Postal Code: | 038852221 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/18/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0297872303 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |