Provider Demographics
NPI:1538949029
Name:BOWER, NOEMI ROGELIA (DNP, FNP-C, RN, PHN)
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:ROGELIA
Last Name:BOWER
Suffix:
Gender:F
Credentials:DNP, FNP-C, RN, PHN
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:ROGELIA
Other - Last Name:VALENZUELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:671 PERIDOT PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-4155
Mailing Address - Country:US
Mailing Address - Phone:951-306-6644
Mailing Address - Fax:
Practice Address - Street 1:671 PERIDOT PL
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-4155
Practice Address - Country:US
Practice Address - Phone:951-306-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily