Provider Demographics
NPI:1821238825
Name:BOWMAN, TAFFIE L (RN, BSN, MSN, ARNP)
Entity Type:Individual
Prefix:
First Name:TAFFIE
Middle Name:L
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:RN, BSN, MSN, ARNP
Other - Prefix:
Other - First Name:TAFFIE
Other - Middle Name:LEE
Other - Last Name:MURPHREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-4000
Mailing Address - Fax:
Practice Address - Street 1:700 W IRONWOOD DR
Practice Address - Street 2:SUITE 320
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2656
Practice Address - Country:US
Practice Address - Phone:208-625-5250
Practice Address - Fax:208-625-5251
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP899A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8880415OtherMEDICARE PTAN
ID808290800Medicaid
ID1349000OtherMEDICARE PTAN