Provider Demographics
NPI:1700047602
Name:BOWE, ADRAENNE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ADRAENNE
Middle Name:
Last Name:BOWE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:ADRAENNE
Other - Middle Name:
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:1 TIME WARNER CTR
Mailing Address - Street 2:10TH FLR., ROOM 10-140
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6038
Mailing Address - Country:US
Mailing Address - Phone:212-484-6912
Mailing Address - Fax:212-484-7269
Practice Address - Street 1:1 TIME WARNER CTR
Practice Address - Street 2:10TH FLR., ROOM 10-140
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6038
Practice Address - Country:US
Practice Address - Phone:212-484-6912
Practice Address - Fax:212-484-7269
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333961-1363LF0000X
NYF380388-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics