MEDICARE: MS. EMILY BOWLING AA

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	367H00000X	Anesthesiologist Assistant	AA2022-003	NM
2	367H00000X	Anesthesiologist Assistant	67.000249	OH

General Provider Information

NPI Number	:	1356724959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY BOWLING AA

Provider Business Mailing Address
First Line	:	118 SAN SALVADOR LN
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1740
Country	:	US
Telephone Number	:	740-646-8366
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 SAN SALVADOR LN
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1740
Country	:	US
Telephone Number	:	740-646-8366
Fax Number	:

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

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	06/19/2025

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