Provider Demographics
NPI:1326091554
Name:BOWER, BONNIE G (NP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:G
Last Name:BOWER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:120-B OSIGIAN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8939
Mailing Address - Country:US
Mailing Address - Phone:478-953-5358
Mailing Address - Fax:478-953-5340
Practice Address - Street 1:1707 WATSON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3606
Practice Address - Country:US
Practice Address - Phone:478-929-8030
Practice Address - Fax:478-929-8095
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA119753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner