Provider Demographics
NPI:1154780450
Name:NP MOBILE MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:NP MOBILE MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-719-2223
Mailing Address - Street 1:11580 MELLOW CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-9125
Mailing Address - Country:US
Mailing Address - Phone:561-267-3345
Mailing Address - Fax:888-939-4244
Practice Address - Street 1:11580 MELLOW CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-9125
Practice Address - Country:US
Practice Address - Phone:561-267-3345
Practice Address - Fax:888-939-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9214512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7511795OtherCIGNA PROVIDER NUMBER
YOM6JOtherBCBS
YOM6JOtherBCBS