Healthcare Provider Details

I. General information

NPI: 1003080276
Provider Name (Legal Business Name): ADRIENNE L BOWMAN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 YORKTOWN DR STE 203
FAYETTEVILLE GA
30214-1578
US

IV. Provider business mailing address

1265 HIGHWAY 54 W SUITE 304
FAYETTEVILLE GA
30214-4548
US

V. Phone/Fax

Practice location:
  • Phone: 770-474-7416
  • Fax: 770-692-0761
Mailing address:
  • Phone: 678-817-4390
  • Fax: 678-817-4394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD003682
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: