Provider Demographics
NPI:1306482609
Name:BOWMAN, AMANDA (NP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-1528
Mailing Address - Country:US
Mailing Address - Phone:304-675-1244
Mailing Address - Fax:
Practice Address - Street 1:146 PINNELL ST STE C
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9101
Practice Address - Country:US
Practice Address - Phone:304-373-1537
Practice Address - Fax:304-974-3469
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV104779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily