Provider Demographics
NPI:1558988733
Name:DOWE, NEIDRA P
Entity Type:Individual
Prefix:
First Name:NEIDRA
Middle Name:P
Last Name:DOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 RAEBURN ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-3050
Mailing Address - Country:US
Mailing Address - Phone:248-884-8736
Mailing Address - Fax:
Practice Address - Street 1:308 RAEBURN ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-3050
Practice Address - Country:US
Practice Address - Phone:248-884-8736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health