Provider Demographics
NPI:1518396597
Name:BOWSER, EMMA S (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:S
Last Name:BOWSER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MRS
Other - First Name:EMMA
Other - Middle Name:S
Other - Last Name:BOWSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:8988 MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1422
Mailing Address - Country:US
Mailing Address - Phone:313-388-3904
Mailing Address - Fax:
Practice Address - Street 1:15100 S PLAZA DR
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5203
Practice Address - Country:US
Practice Address - Phone:734-287-3700
Practice Address - Fax:734-287-3016
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704143963363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health