Provider Demographics
NPI:1376902478
Name:TWILIGHT CONSULTING & MANAGEMENT
Entity Type:Organization
Organization Name:TWILIGHT CONSULTING & MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-566-1603
Mailing Address - Street 1:PO BOX 18666
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27419-8666
Mailing Address - Country:US
Mailing Address - Phone:844-246-1591
Mailing Address - Fax:770-701-6718
Practice Address - Street 1:220 CORDER RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-3604
Practice Address - Country:US
Practice Address - Phone:478-923-5872
Practice Address - Fax:336-553-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G70720OtherMEDICARE