Provider Demographics
NPI:1629592308
Name:BOWDEN, RACHEL LAUREN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAUREN
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 HORNUNG HILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4140
Mailing Address - Country:US
Mailing Address - Phone:502-821-2036
Mailing Address - Fax:
Practice Address - Street 1:509 HORNUNG HILL DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4140
Practice Address - Country:US
Practice Address - Phone:502-821-2036
Practice Address - Fax:502-821-2036
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer