Provider Demographics
NPI:1124300041
Name:BOWMAN, BRINDISHA A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BRINDISHA
Middle Name:A
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:BRINDISHA
Other - Middle Name:A
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3700 S CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-4708
Mailing Address - Country:US
Mailing Address - Phone:504-488-1110
Mailing Address - Fax:504-488-1148
Practice Address - Street 1:3700 S CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-4708
Practice Address - Country:US
Practice Address - Phone:504-488-1110
Practice Address - Fax:504-488-1148
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist