Provider Demographics
NPI:1073587051
Name:BOWMAN, PATTI JO (PA-C)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:JO
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT OF EMERGENCY MEDICINE UK HEALTHCARE
Mailing Address - Street 2:800 ROSE STREET M50
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-5908
Mailing Address - Fax:859-323-8056
Practice Address - Street 1:1000 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1793
Practice Address - Country:US
Practice Address - Phone:859-323-5908
Practice Address - Fax:859-323-8056
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA255363AM0700X, 363AS0400X
KYPA-255363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000377997OtherANTHEM PROVIDER #
KY61-1427889OtherCHA
KY61-1427889OtherTRICARE
KYC60875OtherCUMBERLAND HEALTHCARE INC
KY61-1427889OtherUHC
KY95003034Medicaid
KY030670000OtherBLACK LUNG
KY61-1427889OtherBLUEGRASS FAMILY HEALTH
KY50005618OtherPASSPORT HEALTH PLAN
KY61-1427889OtherHUMANA
KYP30581Medicare UPIN
KY95003034Medicaid