MEDICARE: ELIZABETH B BOWE CNS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364S00000X	Clinical Nurse Specialist	NS-08189	OH
2	363LA2200X	Adult Health Nurse Practitioner	08791	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033172325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH B BOWE CNS

Provider Business Mailing Address
First Line	:	PO BOX 74647
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44194-0730
Country	:	US
Telephone Number	:	440-879-0081
Fax Number	:	440-879-0084

Provider Business Practice Location Address
First Line	:	6780 MAYFIELD RD
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-2203
Country	:	US
Telephone Number	:	440-312-8293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2006
Last Update Date	:	07/28/2021

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