Provider Demographics
NPI:1376953943
Name:BOWEN, SHARON ANN
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:BOWEN
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 1:920 N 8TH ST
Mailing Address - Street 2:PO BOX 431
Mailing Address - City:HOLLIS
Mailing Address - State:OK
Mailing Address - Zip Code:73550-2026
Mailing Address - Country:US
Mailing Address - Phone:580-688-2200
Mailing Address - Fax:
Practice Address - Street 1:920 N 8TH ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:OK
Practice Address - Zip Code:73550-2026
Practice Address - Country:US
Practice Address - Phone:580-688-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK112526364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health