Provider Demographics
NPI:1891922399
Name:BOWMAN, DEBORAH K (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:K
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1320
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:VA
Mailing Address - Zip Code:24521-1320
Mailing Address - Country:US
Mailing Address - Phone:434-946-9565
Mailing Address - Fax:434-946-2766
Practice Address - Street 1:124 AMBRIAR CT
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:VA
Practice Address - Zip Code:24521
Practice Address - Country:US
Practice Address - Phone:434-946-9565
Practice Address - Fax:434-946-2766
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1410363AM0700X
VA0110003272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical