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General NPI Number Information
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NPI Number | 1295303287
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Entity Type | Individual
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Provider Name | SIDNEY BOWDEN
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Gender | Male
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 2391 PRADERA CT APT 104
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City | ALBANY
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State | GA
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Zip | 31707-3373
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Country | US
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Telephone | 229-977-7412
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Fax |
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Provider Business Mailing Address
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Address Line | 2391 PRADERA CT APT 104
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City | ALBANY
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State | GA
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Zip | 31707-3373
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Country | US
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Telephone | 229-977-7412
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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 | RN235485
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License Number State | GA
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