Provider Demographics
NPI:1609128966
Name:BOWEN, JAMES DEAN (RN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DEAN
Last Name:BOWEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BAY GULL CT
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8306
Mailing Address - Country:US
Mailing Address - Phone:386-290-9169
Mailing Address - Fax:
Practice Address - Street 1:7 BAY GULL CT
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-8306
Practice Address - Country:US
Practice Address - Phone:386-290-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9291818163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis