Healthcare Provider Details

I. General information

NPI: 1477388841
Provider Name (Legal Business Name): BOWEN MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21035 N CAVE CREEK RD STE 5C
PHOENIX AZ
85024-5522
US

IV. Provider business mailing address

21035 N CAVE CREEK RD STE 5C
PHOENIX AZ
85024-5522
US

V. Phone/Fax

Practice location:
  • Phone: 602-602-4028
  • Fax:
Mailing address:
  • Phone: 602-402-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARISSA Y BOWEN
Title or Position: FAMILY NURSE PRACTITIONER/OWNER
Credential: FNP-C
Phone: 602-402-8048