Provider Demographics
NPI:1194564534
Name:BOWMAN, DOLORES S (DNP, PMHNP)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:S
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 HORSESHOE BEND LN
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:38560-4131
Mailing Address - Country:US
Mailing Address - Phone:615-839-8672
Mailing Address - Fax:
Practice Address - Street 1:1200 S WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4157
Practice Address - Country:US
Practice Address - Phone:931-432-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36352363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health