Provider Demographics
NPI:1619641354
Name:BOWDEN, COURTNEY L (RN, BSN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 MABELINE RD APT 55C
Mailing Address - Street 2:
Mailing Address - City:HANAHAN
Mailing Address - State:SC
Mailing Address - Zip Code:29410-5349
Mailing Address - Country:US
Mailing Address - Phone:850-585-3122
Mailing Address - Fax:
Practice Address - Street 1:4050 BRIDGE VIEW DR STE 600
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8415
Practice Address - Country:US
Practice Address - Phone:843-953-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9511880251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care