MEDICARE: MARIANNE ZORIO BOWMAN NP

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	363LF0000X	Family Nurse Practitioner	0024176612	VA

General Provider Information

NPI Number	:	1790268977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNE ZORIO BOWMAN NP

Provider Business Mailing Address
First Line	:	1807 DEWITT AVE APT H
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22301-1269
Country	:	US
Telephone Number	:	703-609-2343
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE STE 600
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1314
Country	:	US
Telephone Number	:	703-212-9190
Fax Number	:	703-212-9160

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

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	09/13/2018

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