Healthcare Provider Details

I. General information

NPI: 1154386357
Provider Name (Legal Business Name): ELLEN C. BOWMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 MORPHY AVE
FAIRHOPE AL
36532-1812
US

IV. Provider business mailing address

750 MORPHY AVE
FAIRHOPE AL
36532-1812
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-1109
  • Fax: 251-990-1112
Mailing address:
  • Phone: 251-990-1109
  • Fax: 251-990-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-094739
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: