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NPI Code Detail

MEDICARE: MS. JEANENE HILL BOWMAN NNP-BC

MEDICARE: MS. JEANENE HILL BOWMAN NNP-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
1363LN0005XCritical Care Neonatal Nurse PractitionerRN262015GA

General Provider Information

NPI Number : 1205384211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANENE HILL BOWMAN NNP-BC
Provider Business Mailing Address
First Line : 1711 TULLIE CIR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2305
Country : US
Telephone Number : 404-785-5413
Fax Number :
Provider Business Practice Location Address
First Line : 1711 TULLIE CIR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2305
Country : US
Telephone Number : 404-785-5413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2016
Last Update Date : 09/19/2016

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