Healthcare Provider Details

I. General information

NPI: 1427485275
Provider Name (Legal Business Name): ANNE W BOWDEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 E 2100 S
SALT LAKE CITY UT
84106-2349
US

IV. Provider business mailing address

1053 E 2100 S
SALT LAKE CITY UT
84106-2349
US

V. Phone/Fax

Practice location:
  • Phone: 801-359-3955
  • Fax: 801-359-8489
Mailing address:
  • Phone: 801-359-3955
  • Fax: 801-359-8489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8807202-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: