Healthcare Provider Details

I. General information

NPI: 1417841024
Provider Name (Legal Business Name): ELIZABETH BOWES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 KEMPSVILLE RD STE 205
NORFOLK VA
23502-3957
US

IV. Provider business mailing address

1401 OLD BRANDON AVE
NORFOLK VA
23507-1049
US

V. Phone/Fax

Practice location:
  • Phone: 757-451-0929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024194254
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: