Healthcare Provider Details

I. General information

NPI: 1053174151
Provider Name (Legal Business Name): MORGANA BOWERS RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOSPITAL DR
COLUMBIA MO
65201-5275
US

IV. Provider business mailing address

501 MCBAINE AVE
COLUMBIA MO
65203-3309
US

V. Phone/Fax

Practice location:
  • Phone: 573-814-6000
  • Fax:
Mailing address:
  • Phone: 425-293-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2021031621
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: