Provider Demographics
NPI:1598220451
Name:BOWEN, SERINA (RN, BSN, MED, ATC)
Entity Type:Individual
Prefix:MRS
First Name:SERINA
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:RN, BSN, MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27867 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8978
Mailing Address - Country:US
Mailing Address - Phone:970-216-8786
Mailing Address - Fax:
Practice Address - Street 1:606 4TH ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:NE
Practice Address - Zip Code:68638-3176
Practice Address - Country:US
Practice Address - Phone:308-536-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE77976163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool