Provider Demographics
NPI:1184728685
Name:BOWLING, DIANE F (NP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:F
Last Name:BOWLING
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10432 PATRIOT HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2628
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:540-898-2127
Practice Address - Street 1:10432 PATRIOT HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2628
Practice Address - Country:US
Practice Address - Phone:804-674-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0024167051363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00421667OtherRAILROAD MEDICARE
VA1184728685Medicaid
VAQ71680Medicare UPIN
VA011100L17Medicare PIN