Healthcare Provider Details

I. General information

NPI: 1063371193
Provider Name (Legal Business Name): TAMMY BOWDLE MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 COMMERCIAL CT STE C
VENICE FL
34292-1642
US

IV. Provider business mailing address

425 COMMERCIAL CT STE C
VENICE FL
34292-1642
US

V. Phone/Fax

Practice location:
  • Phone: 941-244-4377
  • Fax: 941-445-4186
Mailing address:
  • Phone: 941-244-4377
  • Fax: 941-445-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11047022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: