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General NPI Number Information
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NPI Number | 1831528868
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Entity Type | Individual
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Provider Name | SAMANTHA SMITH-BOWMAN R.D.
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Gender | Female
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 15400 GREAT GLEN LN
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-8549
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Country | US
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Telephone | 704-408-3043
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Fax |
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Provider Business Mailing Address
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Address Line | 15400 GREAT GLEN LN
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-8549
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Country | US
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Telephone | 704-408-3043
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | L003809
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L003809
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License Number State | NC
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