Healthcare Provider Details

I. General information

NPI: 1598039364
Provider Name (Legal Business Name): SARITA ELAINE BOWERS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2012
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 BERKMORE PL SUITE 1A
BERKELEY SPRINGS WV
25411-6247
US

IV. Provider business mailing address

109 RAYLOC DR
HANCOCK MD
21750-1518
US

V. Phone/Fax

Practice location:
  • Phone: 304-258-5790
  • Fax: 304-258-3745
Mailing address:
  • Phone: 301-678-5187
  • Fax: 301-678-5797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61469
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR162951
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: