Provider Demographics
NPI:1063494672
Name:BLOWEN, JOHN MARK (APRN)
Entity Type:Individual
Prefix:
First Name:JOHN MARK
Middle Name:
Last Name:BLOWEN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MARK AVE
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2221
Mailing Address - Country:US
Mailing Address - Phone:603-852-0513
Mailing Address - Fax:
Practice Address - Street 1:3 MARK AVE
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2221
Practice Address - Country:US
Practice Address - Phone:603-852-0513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0297872303363LF0000X
MECNP81765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily