Healthcare Provider Details

I. General information

NPI: 1538393806
Provider Name (Legal Business Name): LINDSEY J BOWMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 S ARLINGTON AVE
HARRISBURG PA
17109-5004
US

IV. Provider business mailing address

875 S ARLINGTON AVE
HARRISBURG PA
17109-5004
US

V. Phone/Fax

Practice location:
  • Phone: 717-652-1107
  • Fax: 717-652-1142
Mailing address:
  • Phone: 717-652-1107
  • Fax: 717-652-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA002906
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA053838
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0004819
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: