Provider Demographics
NPI:1972345585
Name:BOWLES EDWARDS, ANGELA (CHW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BOWLES EDWARDS
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 FRANCE AVE S STE 210
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5885
Mailing Address - Country:US
Mailing Address - Phone:651-368-6209
Mailing Address - Fax:
Practice Address - Street 1:7760 FRANCE AVE S STE 210
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5885
Practice Address - Country:US
Practice Address - Phone:651-368-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker