Provider Demographics
NPI:1780286591
Name:DOWLER, AMY RENEE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:DOWLER
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 1:7640 E BASE RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47390-8880
Mailing Address - Country:US
Mailing Address - Phone:937-459-7558
Mailing Address - Fax:
Practice Address - Street 1:116 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:OH
Practice Address - Zip Code:45390-1802
Practice Address - Country:US
Practice Address - Phone:937-423-7295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0355846Medicaid