Provider Demographics
NPI: | 1053447680 |
---|---|
Name: | STOWE, CAROL F (RN, CRNA) |
Entity type: | Individual |
Prefix: | |
First Name: | CAROL |
Middle Name: | F |
Last Name: | STOWE |
Suffix: | |
Gender: | F |
Credentials: | RN, CRNA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 44900 60TH ST W |
Mailing Address - Street 2: | |
Mailing Address - City: | LANCASTER |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93536-7618 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 661-948-8581 |
Mailing Address - Fax: | 661-945-8474 |
Practice Address - Street 1: | 44900 60TH ST W |
Practice Address - Street 2: | |
Practice Address - City: | LANCASTER |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93536-7618 |
Practice Address - Country: | US |
Practice Address - Phone: | 661-948-8581 |
Practice Address - Fax: | 661-945-8474 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-02-26 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | RN187362 | 163W00000X |
CA | NA220 | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | |
No | 163W00000X | Nursing Service Providers | Registered Nurse |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | S05774 | Medicare UPIN | |
CA | WNA220C | Medicare ID - Type Unspecified |