MEDICARE: GRACE BOWMAN

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	364SP0812X	Community Psychiatric/Mental Health Clinical Nurse Specialist	SP034823	PA

General Provider Information

NPI Number	:	1710816665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE BOWMAN

Provider Business Mailing Address
First Line	:	PO BOX 3
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-0003
Country	:	US
Telephone Number	:	215-500-7931
Fax Number	:

Provider Business Practice Location Address
First Line	:	6307 LANSDOWNE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-3450
Country	:	US
Telephone Number	:	215-500-7931
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

Similar Medicare Providers

1083940464 — MARTIN REIVICH MD
Practice Location Address:

3450 HAMILTON WALK , 415 STEMMLER HALL
PHILADELPHIA, PA
19104-6118

Practice Phone: 215-662-2632
Practice Fax: 215-349-5629

1679941488 — JANELLA DOBBS
Practice Location Address:

3450 FRANKFORD AVE
PHILADELPHIA, PA
19134-2651

Practice Phone: 267-230-8723
Practice Fax:

1508522624 — SUBSTANTIAL HOME CARE LLC
Practice Location Address:

3450 N 23RD ST
PHILADELPHIA, PA
19140-4707

Practice Phone: 215-687-5366
Practice Fax:

1700982477 — DR. HELENE JOY MORIARTY PHD, RN, CS
Practice Location Address:

3900 WOODLAND AVE , MAILCODE 118
PHILADELPHIA, PA
19104-4551

Practice Phone: 215-823-4078
Practice Fax: 215-823-4069

1598696155 — JOSH M SMITH
Practice Location Address:

1989 N 63RD ST
PHILADELPHIA, PA
19151-2693

Practice Phone: 610-639-1729
Practice Fax:

1184551202 — MR. PHILIP J BANGURA M.ED
Practice Location Address:

6630 LEEDS ST APT 1
PHILADELPHIA, PA
19151-3028

Practice Phone: 484-841-3426
Practice Fax: 484-841-3426

Directions to “ GRACE BOWMAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.