Provider Demographics
NPI:1184325797
Name:BOWEN, JASMINI NEENA (FNP)
Entity type:Individual
Prefix:
First Name:JASMINI
Middle Name:NEENA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 MILL STREET EXT STE D
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-6079
Mailing Address - Country:US
Mailing Address - Phone:601-791-5004
Mailing Address - Fax:
Practice Address - Street 1:2210 MILL STREET EXT STE D
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-6079
Practice Address - Country:US
Practice Address - Phone:601-791-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily