Provider Demographics
NPI:1083123160
Name:BOWEN, SARA A (PCS PROVIDER)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PCS PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3078 MYLES DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-6742
Mailing Address - Country:US
Mailing Address - Phone:775-954-8835
Mailing Address - Fax:
Practice Address - Street 1:3078 MYLES DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-6742
Practice Address - Country:US
Practice Address - Phone:775-954-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7743PCS3747P1801X, 372600000X, 372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV7743PCSOtherSTATE OF NEVADA HEALTH CARE QUALITY AND COMPLIANCE