Provider Demographics
NPI:1285778639
Name:BOWEN, FELESIA R (APN)
Entity type:Individual
Prefix:DR
First Name:FELESIA
Middle Name:R
Last Name:BOWEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:FELESIA
Other - Middle Name:R
Other - Last Name:MCCOVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 TWIN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5359
Mailing Address - Country:US
Mailing Address - Phone:732-833-1589
Mailing Address - Fax:
Practice Address - Street 1:17 TWIN OAKS CT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5359
Practice Address - Country:US
Practice Address - Phone:732-277-0273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08269200363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NN08269200OtherNJ APN LICENSE
NJ26NR08269200OtherNJ RN LICENSE
NJP00201500OtherCDS