Provider Demographics
NPI:1699908574
Name:BOWMAN, ANGELA WILLIAMS (PA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:WILLIAMS
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CROMWELL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-6480
Mailing Address - Country:US
Mailing Address - Phone:540-420-5792
Mailing Address - Fax:
Practice Address - Street 1:120 CROMWELL DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1750
Practice Address - Country:US
Practice Address - Phone:540-420-5792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant