Provider Demographics
NPI:1255744223
Name:BOWERS, TERESA ANN (APRN- FNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:BOWERS
Suffix:
Gender:F
Credentials:APRN- FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-328-0108
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:1425 DUNN AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1437
Practice Address - Country:US
Practice Address - Phone:386-323-9600
Practice Address - Fax:386-323-9695
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily