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General NPI Number Information
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NPI Number | 1134569478
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Entity Type | Individual
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Provider Name | TAMARA L BOWLING FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 230 QUADRAL DR STE B
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City | WADSWORTH
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State | OH
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Zip | 44281-8376
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Country | US
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Telephone | 330-336-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 6995 FAIRHAVEN OVAL DR
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City | MEDINA
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State | OH
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Zip | 44256-6384
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Country | US
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Telephone | 724-494-6482
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Fax |
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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 | COA.14688-NP
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License Number State | OH
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