Provider Demographics
NPI:1912378209
Name:BOWEN, ANGELA DAWN (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9888
Mailing Address - Fax:239-303-0714
Practice Address - Street 1:260 BETH STACEY BLVD # C
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6074
Practice Address - Country:US
Practice Address - Phone:239-343-9888
Practice Address - Fax:239-303-0714
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74920363LF0000X
FLARNP9427767363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259188000Medicaid