Provider Demographics
NPI:1265081467
Name:STOWELL, LONNIE JEAN
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:JEAN
Last Name:STOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624A 210TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024-8002
Mailing Address - Country:US
Mailing Address - Phone:715-441-0159
Mailing Address - Fax:
Practice Address - Street 1:1624A 210TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-8002
Practice Address - Country:US
Practice Address - Phone:715-441-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide