Jowdy, Fred John

Jowdy, Fred John is an sole proprietor health care provider with primary practice located at 2204 Ironwood Pl Ste B , Coeur D Alene ID 83814-2662. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Jowdy, Fred John can be contacted via phone (208) 765-8585.

Contact Information

Primary practice address
2204 Ironwood Pl Ste B Coeur D Alene ID 83814-2662
Phone: (208) 765-8585
Fax: (208) 765-8486
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X IT40000981 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RNA-696A Idaho

Profile Details

NPI number 1588861371
LBN Legal business name Jowdy, Fred John
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2007
Last updated Mar 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588861371 NPPES
Idaho MEDICAID 807814700

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