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NPI Code Detail

MEDICARE: MRS. ANGELA H SULLIVAN-BOWMAN NP-C

MEDICARE:  MRS. ANGELA H SULLIVAN-BOWMAN  NP-C
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
1363LF0000XFamily Nurse Practitioner6046TN
2363LF0000XFamily Nurse PractitionerGAA-NP000772GA

General Provider Information

NPI Number : 1063405553
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA H SULLIVAN-BOWMAN NP-C
Provider Business Mailing Address
First Line : 2717 EAST OAKLAND AVENUE
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-1843
Country : US
Telephone Number : 423-926-2358
Fax Number : 423-926-2680
Provider Business Practice Location Address
First Line : 2403 BATTLEFIELD PARKWAY
Second Line :
City : FT. OGLETHORPE
State : GA
Zip : 30742
Country : US
Telephone Number : 706-866-7700
Fax Number : 423-476-4487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 01/10/2024

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Directions to “ MRS. ANGELA H SULLIVAN-BOWMAN NP-C” Practice Location

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