Provider Demographics
NPI:1215614110
Name:BOWERS, NARIAH
Entity type:Individual
Prefix:
First Name:NARIAH
Middle Name:
Last Name:BOWERS
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:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:BURGESS
Mailing Address - State:VA
Mailing Address - Zip Code:22432-0368
Mailing Address - Country:US
Mailing Address - Phone:804-724-3589
Mailing Address - Fax:
Practice Address - Street 1:109 SIGNATURE WAY APT 633
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5946
Practice Address - Country:US
Practice Address - Phone:804-724-3589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center