Provider Demographics
NPI:1114203932
Name:BOWENS, AVRIL G E
Entity Type:Individual
Prefix:
First Name:AVRIL
Middle Name:G E
Last Name:BOWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 GRADY WIGGINS DR
Mailing Address - Street 2:
Mailing Address - City:OTTO
Mailing Address - State:NC
Mailing Address - Zip Code:28763-8114
Mailing Address - Country:US
Mailing Address - Phone:828-342-8128
Mailing Address - Fax:828-349-0964
Practice Address - Street 1:61 GRADY WIGGINS DR
Practice Address - Street 2:
Practice Address - City:OTTO
Practice Address - State:NC
Practice Address - Zip Code:28763-8114
Practice Address - Country:US
Practice Address - Phone:828-342-8128
Practice Address - Fax:828-349-0964
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI78-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife