1851807259 NPI number — MRS. ALICIA D JOWERS APRN, CNM

Table of content: MRS. ALICIA D JOWERS APRN, CNM (NPI 1851807259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851807259 NPI number — MRS. ALICIA D JOWERS APRN, CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOWERS
Provider First Name:
ALICIA
Provider Middle Name:
D
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851807259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 ANCIENT OAKS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLY SPRINGS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27540-4423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-710-6808
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 ERWIN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710-4423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-710-6808
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  869 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X , with the licence number: APRN9273208 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 024123100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com