Provider Demographics
NPI:1275763047
Name:BOWMAN, REBECCA E (DNP, APRN-C, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:E
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DNP, APRN-C, PMHNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:NULAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,BSN,OCN
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-0458
Mailing Address - Country:US
Mailing Address - Phone:641-684-6896
Mailing Address - Fax:641-226-5759
Practice Address - Street 1:201 S MARKET ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501
Practice Address - Country:US
Practice Address - Phone:641-683-5773
Practice Address - Fax:641-684-6152
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111077363LA2200X, 363LP0808X
IAG146519363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025668100Medicaid