MEDICARE: JENNIFER A. BOWMAN DNP, MBA, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP014192	PA

General Provider Information

NPI Number	:	1003218280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A. BOWMAN DNP, MBA, PMHNP-BC

Provider Business Mailing Address
First Line	:	135 TECHNOLOGY DR STE 204
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-9549
Country	:	US
Telephone Number	:	724-399-3931
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 TECHNOLOGY DR STE 204
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-9549
Country	:	US
Telephone Number	:	724-399-3931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2014
Last Update Date	:	01/05/2024

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