Provider Demographics
NPI:1790398469
Name:BOWDEN, SHELBY LEANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LEANNE
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOWNCENTER BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1832
Mailing Address - Country:US
Mailing Address - Phone:205-462-3334
Mailing Address - Fax:205-469-9586
Practice Address - Street 1:100 TOWNCENTER BLVD STE 112
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1832
Practice Address - Country:US
Practice Address - Phone:205-462-3334
Practice Address - Fax:205-469-9586
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-154143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily