Provider Demographics
NPI:1346335239
Name:BOWMAN, FELICIA S
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:S
Last Name:BOWMAN
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 1:1016 HURON RD
Mailing Address - Street 2:
Mailing Address - City:ARNAUDVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70512-3721
Mailing Address - Country:US
Mailing Address - Phone:337-228-6306
Mailing Address - Fax:636-773-5327
Practice Address - Street 1:103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-5113
Practice Address - Country:US
Practice Address - Phone:337-442-6306
Practice Address - Fax:636-773-5327
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies