Provider Demographics
NPI:1891175634
Name:BOWEN, CAITLIN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11256 PERSINGER CIR
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-4970
Mailing Address - Country:US
Mailing Address - Phone:205-218-7153
Mailing Address - Fax:205-343-7825
Practice Address - Street 1:4960 RICE MINE RD NE STE 40
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3136
Practice Address - Country:US
Practice Address - Phone:205-759-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1176626OtherFAMILY MEDICINE