Provider Demographics
NPI:1609943406
Name:BOWERS, DORIS C (RN)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:C
Last Name:BOWERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1550
Mailing Address - Country:US
Mailing Address - Phone:614-252-4611
Mailing Address - Fax:614-258-5000
Practice Address - Street 1:163 N 20TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1550
Practice Address - Country:US
Practice Address - Phone:614-252-4611
Practice Address - Fax:614-258-5000
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN227720163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0228597Medicaid