Provider Demographics
NPI:1528129004
Name:BOWER, REBECCA S (LPN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BOWER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2622
Mailing Address - Country:US
Mailing Address - Phone:740-887-3227
Mailing Address - Fax:
Practice Address - Street 1:172 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2622
Practice Address - Country:US
Practice Address - Phone:740-775-8385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN071222164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2676162OtherODJFS INDEPENDENT PROVIDE