Provider Demographics
NPI:1205073442
Name:BOWEN, LEAH GARRETT (PMHNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:GARRETT
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 23RD AVE S
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3133
Mailing Address - Country:US
Mailing Address - Phone:615-936-3555
Mailing Address - Fax:615-322-4856
Practice Address - Street 1:1601 23RD AVE S
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3133
Practice Address - Country:US
Practice Address - Phone:615-936-3555
Practice Address - Fax:615-322-4856
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN123163163WP0807X
TN7870363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent