Provider Demographics
NPI:1396905196
Name:BOWERS, JEAN G (RN, FNP)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:G
Last Name:BOWERS
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:ELIZABETH
Other - Last Name:GULLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3934 GUINN RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-2809
Mailing Address - Country:US
Mailing Address - Phone:865-806-1711
Mailing Address - Fax:
Practice Address - Street 1:3934 GUINN RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-2809
Practice Address - Country:US
Practice Address - Phone:865-806-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN(RN) 42259 (NP)5336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily