Provider Demographics
NPI:1942407978
Name:BLOWE, SHAWNA MARIE (NP)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MARIE
Last Name:BLOWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10805 HURLEY CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6478
Mailing Address - Country:US
Mailing Address - Phone:804-346-1551
Mailing Address - Fax:804-915-0035
Practice Address - Street 1:7650 E PARHAM RD STE 304
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4306
Practice Address - Country:US
Practice Address - Phone:804-346-1551
Practice Address - Fax:804-915-0035
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167291363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024167291OtherSTATE LICENSE