Provider Demographics
NPI:1407520687
Name:JOWELL, SHAMARIE (LVN)
Entity Type:Individual
Prefix:
First Name:SHAMARIE
Middle Name:
Last Name:JOWELL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 STORI LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-0925
Mailing Address - Country:US
Mailing Address - Phone:409-920-3940
Mailing Address - Fax:
Practice Address - Street 1:9301 STORI LN
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-0925
Practice Address - Country:US
Practice Address - Phone:409-920-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152506164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse