=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093738429
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CURTIS OLIVER BOW JR. N.P.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2006
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5091 E JACKSON ST
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47303-4486
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-468-6337
-----------------------------------------------------
Fax | 765-896-8186
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7109 N WILLIAMSON RD
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47303-9510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-281-8982
-----------------------------------------------------
Fax | 765-281-8982
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 71001195A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 71001195A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------