Healthcare Provider Details

I. General information

NPI: 1902711997
Provider Name (Legal Business Name): GENEVA BOWENS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6916 GEO LN
HOLLYWOOD SC
29449-6137
US

IV. Provider business mailing address

6916 GEO LN
HOLLYWOOD SC
29449-6137
US

V. Phone/Fax

Practice location:
  • Phone: 470-210-8736
  • Fax:
Mailing address:
  • Phone: 470-210-8736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number10102428
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: