1750799466 NPI number — EMILY BOWDEN RN, FNP-C

Table of content: EMILY BOWDEN RN, FNP-C (NPI 1750799466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750799466 NPI number — EMILY BOWDEN RN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWDEN
Provider First Name:
EMILY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750799466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 117475
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75011-7475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-495-7246
Provider Business Mailing Address Fax Number:
210-495-7245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 PARK BEND DR STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78758-5388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-495-7245
Provider Business Practice Location Address Fax Number:
210-495-7246
Provider Enumeration Date:
07/25/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  AP126049 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: AP126049 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP126049 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 342245303 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 342245304 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".