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General NPI Number Information
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NPI Number | 1740308543
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Entity Type | Individual
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Provider Name | PAMELA GRAY BOWEN CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 1720 2ND AVE S NB 416
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City | BIRMINGHAM
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State | AL
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Zip | 35294-0113
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Country | US
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Telephone | 205-934-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 FOREST RD
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City | PLEASANT GROVE
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State | AL
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Zip | 35127-3510
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Country | US
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Telephone | 205-744-8418
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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 | 1058291
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License Number State | AL
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