Basic Information
Provider Information
NPI: 1033595947
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOWDERS
FirstName: BRITTANY
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 165 NATCHEZ TRACE AVE
Address2: SUITE 205
City: BOWLING GREEN
State: KY
PostalCode: 421037940
CountryCode: US
TelephoneNumber: 2703931912
FaxNumber: 2703931913
Practice Location
Address1: 165 NATCHEZ TRACE AVE
Address2: SUITE 205
City: BOWLING GREEN
State: KY
PostalCode: 421037940
CountryCode: US
TelephoneNumber: 2703931912
FaxNumber: 2703931913
Other Information
ProviderEnumerationDate: 08/03/2015
LastUpdateDate: 11/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3009597KYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000X3009597KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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