Provider Demographics
NPI:1235472317
Name:GAYLE M. BOWEN APRN,BC,PLLC
Entity Type:Organization
Organization Name:GAYLE M. BOWEN APRN,BC,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS,APRN,BC
Authorized Official - Phone:603-622-5951
Mailing Address - Street 1:1361 ELM ST
Mailing Address - Street 2:SUITE 407B
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1324
Mailing Address - Country:US
Mailing Address - Phone:603-622-5951
Mailing Address - Fax:603-622-6028
Practice Address - Street 1:1361 ELM ST
Practice Address - Street 2:SUITE 407B
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1324
Practice Address - Country:US
Practice Address - Phone:603-622-5951
Practice Address - Fax:603-622-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH015728-23103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNS6007Medicare PIN