Provider Demographics
NPI:1972044048
Name:DEWONA FLOWERS
Entity Type:Organization
Organization Name:DEWONA FLOWERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DEWONA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-259-4771
Mailing Address - Street 1:604 LEXINGTON CV
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-3004
Mailing Address - Country:US
Mailing Address - Phone:601-259-4771
Mailing Address - Fax:
Practice Address - Street 1:604 LEXINGTON CV
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-3004
Practice Address - Country:US
Practice Address - Phone:601-259-4771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901392261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA