Provider Demographics
NPI:1770989444
Name:SOWERS, RICHARD JASON (RN)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JASON
Last Name:SOWERS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 BABBLING BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-2512
Mailing Address - Country:US
Mailing Address - Phone:937-514-3252
Mailing Address - Fax:
Practice Address - Street 1:513 BABBLING BROOKE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-2512
Practice Address - Country:US
Practice Address - Phone:937-514-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH375995163W00000X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse