Provider Demographics
NPI:1043900749
Name:BOWER, GENEVIEVE (RN, BSN, MS, IBCLC)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:BOWER
Suffix:
Gender:F
Credentials:RN, BSN, MS, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4547 BRIGHTS PIKE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-6714
Mailing Address - Country:US
Mailing Address - Phone:865-309-1793
Mailing Address - Fax:
Practice Address - Street 1:4547 BRIGHTS PIKE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-6714
Practice Address - Country:US
Practice Address - Phone:865-309-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN199653163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant