MEDICARE: RANDY BOWMAN

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1497548408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY BOWMAN

Provider Business Mailing Address
First Line	:	7920 JASPENCE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5179
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5045 HARRISON DR APT 222
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-1089
Country	:	US
Telephone Number	:	725-425-3702
Fax Number	:

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

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

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Directions to “ RANDY BOWMAN ” Practice Location

Language	Start Address	Practice Location

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