Provider Demographics
NPI:1689063455
Name:BOWMAN, YVETTE-BENITA (HHA,CNA,PCT)
Entity Type:Individual
Prefix:
First Name:YVETTE-BENITA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:HHA,CNA,PCT
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 20755
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-0862
Mailing Address - Country:US
Mailing Address - Phone:347-231-7535
Mailing Address - Fax:
Practice Address - Street 1:1 BOXER CT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4218
Practice Address - Country:US
Practice Address - Phone:347-231-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334329164W00000X
NY343564860614E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse