Provider Demographics
NPI:1740005172
Name:BOWMAN, JANELLE E
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:E
Last Name:BOWMAN
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 1:303 E TECUMSEH DR
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-1982
Mailing Address - Country:US
Mailing Address - Phone:812-318-4782
Mailing Address - Fax:
Practice Address - Street 1:303 E TECUMSEH DR
Practice Address - Street 2:
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429-1982
Practice Address - Country:US
Practice Address - Phone:812-318-4782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24015421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health