Provider Demographics
NPI:1659683522
Name:BOWER, MARJORIE ANN (RN)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:ANN
Last Name:BOWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 1095
Mailing Address - Street 2:
Mailing Address - City:HARDIN
Mailing Address - State:MT
Mailing Address - Zip Code:59034-9713
Mailing Address - Country:US
Mailing Address - Phone:406-638-3484
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 1095
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-9713
Practice Address - Country:US
Practice Address - Phone:406-638-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse