Provider Demographics
NPI:1962845743
Name:JOWERS, BETHANY JOANNA (LPN)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:JOANNA
Last Name:JOWERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 FANNIE CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:DARDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38328-4826
Mailing Address - Country:US
Mailing Address - Phone:731-845-3186
Mailing Address - Fax:
Practice Address - Street 1:90 RUSH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2241
Practice Address - Country:US
Practice Address - Phone:731-968-8148
Practice Address - Fax:731-968-4777
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN74856164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse