Provider Demographics
NPI:1215534987
Name:BOWEN, CYNTHIA LYNN
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:BOWEN
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 1:3952 RIVER BEND RD
Mailing Address - Street 2:
Mailing Address - City:CRUM
Mailing Address - State:WV
Mailing Address - Zip Code:25669-8125
Mailing Address - Country:US
Mailing Address - Phone:304-962-7229
Mailing Address - Fax:
Practice Address - Street 1:3952 RIVER BEND RD
Practice Address - Street 2:
Practice Address - City:CRUM
Practice Address - State:WV
Practice Address - Zip Code:25669-8125
Practice Address - Country:US
Practice Address - Phone:304-962-7229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant