Provider Demographics
NPI:1114394988
Name:BOWEN, SHIRLANE A (APN)
Entity Type:Individual
Prefix:MISS
First Name:SHIRLANE
Middle Name:A
Last Name:BOWEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CROMWELL CT
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2223
Mailing Address - Country:US
Mailing Address - Phone:609-638-0836
Mailing Address - Fax:
Practice Address - Street 1:2703 US HIGHWAY 130 STE 100
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4721
Practice Address - Country:US
Practice Address - Phone:732-934-4892
Practice Address - Fax:732-838-1905
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00522800363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1114394988OtherFAMILY
NJ1114394988Medicaid