Provider Demographics
NPI:1215632559
Name:BOWMAN, BRITTNI (NP)
Entity type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10273 STATE ROUTE 775
Mailing Address - Street 2:
Mailing Address - City:SCOTTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45678-9072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 N CAROL MALONE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1566
Practice Address - Country:US
Practice Address - Phone:606-225-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV115910363LF0000X
OHAPRN.CNP.0033570363LF0000X
KY4005316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily