Provider Demographics
NPI:1376912501
Name:BOWEN CARE LLC
Entity Type:Organization
Organization Name:BOWEN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-486-3480
Mailing Address - Street 1:6511 SADDLEBACK CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-0762
Mailing Address - Country:US
Mailing Address - Phone:901-486-3480
Mailing Address - Fax:901-203-0341
Practice Address - Street 1:6511 SADDLEBACK CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-0762
Practice Address - Country:US
Practice Address - Phone:901-486-3480
Practice Address - Fax:901-203-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty