Doctor Name: | TIMOTHY L BOWMAN |
NPI Number: | 1760748669 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNP |
License Number: | SP012027 |
Business Practice Address: | 4252 Ridge Rd Stoystown, PA - 155638723 |
Business Phone Number: | 8144420219 |
Business Fax Number: | |
Mailing Address: | 4252 Ridge Rd, STOYSTOWN |
State: | PA |
Postal Code: | 155638723 |
Phone Number: | 8144420219 |
Fax Number: | |
NPI Enumeration Date: | 04/04/2012 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP012027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |