Healthcare Provider Details

I. General information

NPI: 1669516019
Provider Name (Legal Business Name): ANN BOWENS RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N JACKSON ST P.O. DRAWER 1348
AMERICUS GA
31709-3015
US

IV. Provider business mailing address

415 N JACKSON ST P.O. DRAWER 1348
AMERICUS GA
31709-3015
US

V. Phone/Fax

Practice location:
  • Phone: 229-931-2470
  • Fax: 229-931-2474
Mailing address:
  • Phone: 229-931-2470
  • Fax: 229-931-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN071302
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: