Provider Demographics
NPI:1154696607
Name:JOWERS, ALLISON DIANE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:DIANE
Last Name:JOWERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STEELE
Mailing Address - State:MO
Mailing Address - Zip Code:63877-1436
Mailing Address - Country:US
Mailing Address - Phone:573-695-2181
Mailing Address - Fax:573-695-2796
Practice Address - Street 1:216 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STEELE
Practice Address - State:MO
Practice Address - Zip Code:63877-1436
Practice Address - Country:US
Practice Address - Phone:573-695-2181
Practice Address - Fax:573-695-2796
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013041112363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical