Provider Demographics
NPI:1740066455
Name:BOWSER, JANE CROYLE (EDD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:CROYLE
Last Name:BOWSER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 WINSLOW LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5736
Mailing Address - Country:US
Mailing Address - Phone:828-406-4283
Mailing Address - Fax:
Practice Address - Street 1:2512 REYNOLDA RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-4618
Practice Address - Country:US
Practice Address - Phone:336-306-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach