Healthcare Provider Details

I. General information

NPI: 1699837245
Provider Name (Legal Business Name): SUSAN BETH BOWMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EMERGENCY ROOM DR JAMES A TAYLOR BUILDING CB#7470 UNC-CH
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

320 EMERGENCY ROOM DR JAMES A TAYLOR BUILDING CB#7470 UNC-CH
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-3650
  • Fax: 919-966-6248
Mailing address:
  • Phone: 919-966-3650
  • Fax: 919-966-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number109449
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: