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General NPI Number Information
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NPI Number | 1316181670
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Entity Type | Individual
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Provider Name | ROBERT LANE BOWEN
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Gender | Male
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 32 TIMOTHY LN
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City | CONWAY
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State | AR
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Zip | 72034-4959
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Country | US
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Telephone | 501-327-9017
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Fax |
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Provider Business Mailing Address
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Address Line | 32 TIMOTHY LN
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City | CONWAY
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State | AR
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Zip | 72034-4959
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Country | US
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Telephone |
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | A03118
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | A003118
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License Number State | AR
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