Provider Demographics
NPI:1184677429
Name:DOWLING, JO L (NP)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:L
Last Name:DOWLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HOSPITAL DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-5009
Mailing Address - Country:US
Mailing Address - Phone:802-442-4785
Mailing Address - Fax:802-447-3459
Practice Address - Street 1:140 HOSPITAL DR
Practice Address - Street 2:SUITE 215
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-5009
Practice Address - Country:US
Practice Address - Phone:802-442-4785
Practice Address - Fax:802-447-3459
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010019869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4000052Medicaid
VT4000052Medicaid
VTS01057Medicare UPIN