Provider Demographics
NPI:1912203241
Name:DOWE, KELLY REBECCA (NP-C)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:REBECCA
Last Name:DOWE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MONTEVUE LN
Mailing Address - Street 2:HILLCREST SCHOOL BASED HEALTH CENTER
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8214
Mailing Address - Country:US
Mailing Address - Phone:301-600-3103
Mailing Address - Fax:
Practice Address - Street 1:1285 HILLCREST DR
Practice Address - Street 2:SCHOOL BASED HEALTH CENTER
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-1396
Practice Address - Country:US
Practice Address - Phone:240-236-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR135431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily