Provider Demographics
NPI:1699961755
Name:BOWEN, SUSANA (RNFA)
Entity type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 CRESTHAVEN PLACE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056
Mailing Address - Country:US
Mailing Address - Phone:760-805-0500
Mailing Address - Fax:760-842-1764
Practice Address - Street 1:628 EAST ELDER
Practice Address - Street 2:FALLBROOK HOSPITAL
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028
Practice Address - Country:US
Practice Address - Phone:760-731-8451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480912163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant