Healthcare Provider Details

I. General information

NPI: 1003410697
Provider Name (Legal Business Name): MORGAN BOWEN DNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4572 S HAGADORN RD STE 1G
EAST LANSING MI
48823-5385
US

IV. Provider business mailing address

1135 N GENESEE DR
LANSING MI
48915-1909
US

V. Phone/Fax

Practice location:
  • Phone: 517-325-5224
  • Fax: 517-659-6444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704302358
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number4704302358
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: