Provider Demographics
NPI:1124089487
Name:BOWMAN, BOBBIANN MARIE
Entity type:Individual
Prefix:
First Name:BOBBIANN
Middle Name:MARIE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WOODSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-1805
Mailing Address - Country:US
Mailing Address - Phone:240-277-6950
Mailing Address - Fax:
Practice Address - Street 1:1001 HOLCOLM RD
Practice Address - Street 2:NSHS PORTSMOUTH
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-953-5047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians