MEDICARE: PATRICIA LOUISE BOWMAN CFNP

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	363LF0000X	Family Nurse Practitioner	33063	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598091456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LOUISE BOWMAN CFNP

Provider Business Mailing Address
First Line	:	100 PADUCAH DR
Second Line	:	SUITE B
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2710
Country	:	US
Telephone Number	:	304-447-4000
Fax Number	:	304-455-2870

Provider Business Practice Location Address
First Line	:	100 PADUCAH DR
Second Line	:	SUITE B
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2710
Country	:	US
Telephone Number	:	304-447-4000
Fax Number	:	304-455-2870

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

Provider Enumeration Date	:	10/28/2009
Last Update Date	:	03/03/2014

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