Provider Demographics
NPI:1467464784
Name:STOWE, NINA J (CRNP)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:J
Last Name:STOWE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 HWY. 43, SUITE 24
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35653-0221
Mailing Address - Country:US
Mailing Address - Phone:256-398-7212
Mailing Address - Fax:256-398-7213
Practice Address - Street 1:14001 HWY. 43, SUITE 24
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-0221
Practice Address - Country:US
Practice Address - Phone:256-398-7212
Practice Address - Fax:256-398-7213
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1047048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51526169OtherBLUE CROSS