| Organization Name: | JANET R BOWEN, LLC |
| NPI Number: | 1255770756 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANET R BOWEN (NURSE PRACTITIONER) |
| Mailing Address: | 1106 4th Ave Woodruff |
| State: | WI US |
| Postal Code: | 545689481 |
| Phone Number: | 7153587727 |
| Fax Number: | 7153587525 |
| NPI Enumeration Date: | 06/18/2013 |
| NPI Last Update Date: | 03/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 57301-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |