Provider Demographics
NPI:1710159777
Name:DOWUONA, ETHEL PEARL (RN)
Entity Type:Individual
Prefix:MRS
First Name:ETHEL
Middle Name:PEARL
Last Name:DOWUONA
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 1:1300 VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-2231
Mailing Address - Country:US
Mailing Address - Phone:254-867-1181
Mailing Address - Fax:
Practice Address - Street 1:3115 BELLMEAD DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705-3032
Practice Address - Country:US
Practice Address - Phone:254-867-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529977163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management