Provider Demographics
NPI:1831137793
Name:KOWALSKI, JAMIE LEE (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:LEE
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14397 MARSH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:NY
Mailing Address - Zip Code:14477-9711
Mailing Address - Country:US
Mailing Address - Phone:585-682-0548
Mailing Address - Fax:716-862-6555
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8858
Practice Address - Fax:716-862-6555
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF 333691-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily