Individual provider Active NPI

Renee Ann Bowzer, RN

  • Registered Nurse
  • Stanwood, WA
National Provider Identifier
1528310059
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00074570 Issued in WA
Practice address
31503 W Lake Ketchum Rd
Stanwood, WA 98292-9710
Phone
(360) 629-4349
NPI assigned
Oct 8, 2012
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00074570 WA Primary

Addresses

Primary practice location

31503 W Lake Ketchum Rd
Stanwood, WA 98292-9710

Mailing address

31503 W Lake Ketchum Rd
Stanwood, WA 98292-9710
Phone (360) 629-4349

Other names 1

  • Renee Randall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00074570WAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1528310059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31503 W LAKE KETCHUM RD",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982929710",
            "telephone_number": "360-629-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31503 W LAKE KETCHUM RD",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982929710",
            "telephone_number": "360-629-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWZER",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00074570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "RANDALL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.