1265290266 NPI number — ANGEL MARIE BOWENS C.N.A

Table of content: ANGEL MARIE BOWENS C.N.A (NPI 1265290266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265290266 NPI number — ANGEL MARIE BOWENS C.N.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWENS
Provider First Name:
ANGEL
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
C.N.A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOWENS
Provider Other First Name:
ANGEL
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1265290266
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
312 CENTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW RICHMOND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45157-1103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-449-4483
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
312 CENTER ST NEW RICHMOND OHIO 45157
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW RICHMOND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-581-7749
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2024

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: 376J00000X , with the licence number:  376J00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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