Provider Demographics
NPI:1841080165
Name:MOWERY, CHARITY (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:
Last Name:MOWERY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 SHERIDAN ST STE X
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3513
Mailing Address - Country:US
Mailing Address - Phone:561-632-2279
Mailing Address - Fax:
Practice Address - Street 1:4401 SHERIDAN ST STE X
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3513
Practice Address - Country:US
Practice Address - Phone:561-632-2279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily