Provider Demographics
NPI:1437921095
Name:BOWEN, CIELITO MARIE BUNDANG (DNP, FNP-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:CIELITO MARIE
Middle Name:BUNDANG
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DNP, FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12113 E MAPLE SPRINGS WAY STE B
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9648
Mailing Address - Country:US
Mailing Address - Phone:907-744-1944
Mailing Address - Fax:
Practice Address - Street 1:12113 E MAPLE SPRINGS WAY STE B
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9648
Practice Address - Country:US
Practice Address - Phone:907-744-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK212354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily