Provider Demographics
NPI:1811238116
Name:BOWERS, MEGAN MCNULTY (FNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MCNULTY
Last Name:BOWERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 OMNI DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-9448
Mailing Address - Country:US
Mailing Address - Phone:864-885-7425
Mailing Address - Fax:864-885-7428
Practice Address - Street 1:109 OMNI DR
Practice Address - Street 2:SUITE B
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-9448
Practice Address - Country:US
Practice Address - Phone:864-885-7425
Practice Address - Fax:864-885-7428
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily