Provider Demographics
NPI:1306077961
Name:A WOMANS LIFE FAMILY HEALTHCARE CENTER
Entity type:Organization
Organization Name:A WOMANS LIFE FAMILY HEALTHCARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER/NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:573-334-7006
Mailing Address - Street 1:36 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4904
Mailing Address - Country:US
Mailing Address - Phone:573-334-7006
Mailing Address - Fax:573-334-7090
Practice Address - Street 1:36 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4904
Practice Address - Country:US
Practice Address - Phone:573-334-7006
Practice Address - Fax:573-334-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty