Provider Demographics
NPI:1588488373
Name:BOWMAN, TAMIKA SHAWNDALYNNE
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:SHAWNDALYNNE
Last Name:BOWMAN
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 1:19201 VAN AKEN BLVD APT 503
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3511
Mailing Address - Country:US
Mailing Address - Phone:216-333-5060
Mailing Address - Fax:
Practice Address - Street 1:19201 VAN AKEN BLVD APT 503
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-3511
Practice Address - Country:US
Practice Address - Phone:216-333-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health