Healthcare Provider Details

I. General information

NPI: 1083991590
Provider Name (Legal Business Name): ANDREA G BOWDEN-EVANS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 MCFARLAND BLVD STE 206
NORTHPORT AL
35476-3275
US

IV. Provider business mailing address

1325 MCFARLAND BLVD STE 206
NORTHPORT AL
35476-3275
US

V. Phone/Fax

Practice location:
  • Phone: 205-330-4959
  • Fax: 205-330-4992
Mailing address:
  • Phone: 205-330-4959
  • Fax: 205-330-4992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number1-054401
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: