Provider Demographics
NPI:1356483754
Name:BOWER, WENDY ELSA (RN)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ELSA
Last Name:BOWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:745 RUSSEL ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487
Practice Address - Country:US
Practice Address - Phone:970-871-7623
Practice Address - Fax:970-870-1326
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82310163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse