Provider Demographics
NPI:1285865477
Name:BOWERS, DEBRA ANNE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANNE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 SUNHILL TER
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13207-1025
Mailing Address - Country:US
Mailing Address - Phone:315-744-6380
Mailing Address - Fax:
Practice Address - Street 1:184 SUNHILL TER
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13207-1025
Practice Address - Country:US
Practice Address - Phone:315-744-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406546163WA2000X
NY403649363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator