Provider Demographics
NPI:1932101672
Name:BOWER, DEBORAH A (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:BOWER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4901 GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-5935
Mailing Address - Country:US
Mailing Address - Phone:850-477-7042
Mailing Address - Fax:850-474-9060
Practice Address - Street 1:4901 GRANDE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5935
Practice Address - Country:US
Practice Address - Phone:850-477-7042
Practice Address - Fax:850-474-9060
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP733572367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009959250Medicaid
FLG2867OtherBLUECROSS & BLUESHIELD
FL430067491OtherRAILROAD MEDICARE
AL59051229OtherBLUECROSS & BLUESHIELD
FL303918800Medicaid
FLG2867ZMedicare PIN