Provider Demographics
NPI:1114697463
Name:BOWERS, JAMES GLAYD (DNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GLAYD
Last Name:BOWERS
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W ARIZONA PAVILIONS DR APT 7107
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-6819
Mailing Address - Country:US
Mailing Address - Phone:208-206-3028
Mailing Address - Fax:
Practice Address - Street 1:6375 SW 38TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4840
Practice Address - Country:US
Practice Address - Phone:208-206-3028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN197344367500000X
AZ137088367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered