Provider Demographics
NPI:1518501154
Name:BOWDOIN, ELIZABETH MARIE (BSN, RN, CNOR, RNFA)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:BOWDOIN
Suffix:
Gender:F
Credentials:BSN, RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 COUNTY ROAD 4001
Mailing Address - Street 2:
Mailing Address - City:HOLTS SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:65043-2529
Mailing Address - Country:US
Mailing Address - Phone:660-988-4196
Mailing Address - Fax:
Practice Address - Street 1:11920 COUNTY ROAD 4001
Practice Address - Street 2:
Practice Address - City:HOLTS SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:65043-2529
Practice Address - Country:US
Practice Address - Phone:660-988-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003013746163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant