Provider Demographics
NPI:1619567666
Name:BOWDEN, ANGEL (AGNP)
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1971
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28329-1971
Mailing Address - Country:US
Mailing Address - Phone:910-379-7687
Mailing Address - Fax:
Practice Address - Street 1:2150 HULL RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-2052
Practice Address - Country:US
Practice Address - Phone:800-979-9595
Practice Address - Fax:248-662-9845
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013991363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology