Provider Demographics
NPI:1740259753
Name:MOWREY, ANTHONY DAVID (APRN, NP, DNP, FNP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DAVID
Last Name:MOWREY
Suffix:
Gender:M
Credentials:APRN, NP, DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 E HIGHWAY 138 STE 210
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4028
Mailing Address - Country:US
Mailing Address - Phone:435-200-1208
Mailing Address - Fax:435-200-1057
Practice Address - Street 1:576 E HIGHWAY 138 STE 210
Practice Address - Street 2:
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-4028
Practice Address - Country:US
Practice Address - Phone:435-200-1208
Practice Address - Fax:435-200-1057
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11395654-4405363LF0000X
CANP14539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABJ057ZMedicare PIN