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General NPI Number Information
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NPI Number | 1053841254
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Entity Type | Individual
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Provider Name | AMANDA SUE BOWMAN NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 629 LINCOLN AVE
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City | BEDFORD
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State | IN
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Zip | 47421-2142
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Country | US
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Telephone | 812-675-4470
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Fax | 812-675-4469
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Provider Business Mailing Address
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Address Line | 420 W LONGEST ST
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City | PAOLI
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State | IN
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Zip | 47454-8821
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Country | US
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Telephone | 812-723-3944
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Fax | 812-723-7989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007172A
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License Number State | IN
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