Provider Demographics
NPI:1538647573
Name:BOWERS, MAEGAN
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:BOWERS
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 1:509 CATO RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3630
Mailing Address - Country:US
Mailing Address - Phone:615-397-6155
Mailing Address - Fax:
Practice Address - Street 1:509 CATO RIDGE CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3630
Practice Address - Country:US
Practice Address - Phone:615-397-6155
Practice Address - Fax:615-953-6911
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333300000X, 372600000X, 3747P1801X, 376J00000X, 385H00000X
TNI000000024061253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ045553Medicaid