Healthcare Provider Details

I. General information

NPI: 1093243420
Provider Name (Legal Business Name): ERIC E BOWERS CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIC E BOWERS CNP

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 COTTONVILLE RD
JAMESTOWN OH
45335-1518
US

IV. Provider business mailing address

3131 NEWMARK DR STE 220
MIAMISBURG OH
45342-5400
US

V. Phone/Fax

Practice location:
  • Phone: 937-675-2870
  • Fax: 937-675-2873
Mailing address:
  • Phone: 937-436-4658
  • Fax: 937-436-4984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN.322834
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number020915
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.020915
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: