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General NPI Number Information
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NPI Number | 1609239425
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Entity Type | Individual
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Provider Name | COURTNEY L BOWLES FNP
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Gender | Male
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 701 MORGANTON SQUARE DR
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City | MARYVILLE
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State | TN
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Zip | 37801-4796
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Country | US
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Telephone | 865-982-7101
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Fax | 833-908-2132
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Provider Business Mailing Address
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Address Line | 1275 DICK LONAS RD UNIT 101
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City | KNOXVILLE
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State | TN
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Zip | 37909-1383
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Country | US
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Telephone | 865-584-4747
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Fax | 865-381-1509
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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 | 20853
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024173841
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24012
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License Number State | SC
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