Provider Demographics
NPI:1689935595
Name:BOWEN, JUDITH LYNN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:LYNN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 STRUTHERS RD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2617
Mailing Address - Country:US
Mailing Address - Phone:863-651-4901
Mailing Address - Fax:
Practice Address - Street 1:1032 MANN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4121
Practice Address - Country:US
Practice Address - Phone:407-518-7277
Practice Address - Fax:407-518-7280
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9243025363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health