Provider Demographics
NPI:1003538596
Name:BOWSER, LORI (APRN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 S HIGHLAND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3019
Mailing Address - Country:US
Mailing Address - Phone:801-685-7246
Mailing Address - Fax:801-747-5487
Practice Address - Street 1:6750 S HIGHLAND DR STE 100
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3019
Practice Address - Country:US
Practice Address - Phone:801-685-7246
Practice Address - Fax:801-747-5487
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9405985-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily