Healthcare Provider Details

I. General information

NPI: 1821297284
Provider Name (Legal Business Name): EUGENE WAYRON BOWERS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

21589 OMAHA AVE
PARKER CO
80138-7240
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-2829
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number63759
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: