Provider Demographics
NPI:1558125302
Name:BLOWERS, LOGAN ARNOLD
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:ARNOLD
Last Name:BLOWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7531 YANCY DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-3305
Mailing Address - Country:US
Mailing Address - Phone:402-326-6073
Mailing Address - Fax:
Practice Address - Street 1:7930 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2500
Practice Address - Country:US
Practice Address - Phone:402-420-2020
Practice Address - Fax:314-741-4947
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program