Provider Demographics
NPI:1093966392
Name:BOWE, HERBERT RANDALL (RN)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:RANDALL
Last Name:BOWE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827
Mailing Address - Street 2:BOX 51
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09617-9998
Mailing Address - Country:US
Mailing Address - Phone:01139081-811-6150
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 51
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09617-9998
Practice Address - Country:US
Practice Address - Phone:01139081-811-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX736975163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse