Healthcare Provider Details

I. General information

NPI: 1649849266
Provider Name (Legal Business Name): TAYLOR BOWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE STE MUW -405
SAN FRANCISCO CA
94143-2203
US

IV. Provider business mailing address

10105 BUCKTHORNE DR
SODDY DAISY TN
37379-3581
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberGA-NP000258
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP95040115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: