Provider Demographics
NPI:1255187969
Name:BOWMAN, MADISON (MSN, APRN, AGPCNP-C)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10266 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9405
Mailing Address - Country:US
Mailing Address - Phone:419-773-0326
Mailing Address - Fax:
Practice Address - Street 1:3958 BROWN PARK DR STE D
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1160
Practice Address - Country:US
Practice Address - Phone:419-773-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH507447163WC0200X
OHAG06240103363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine