Provider Demographics
NPI:1295746659
Name:BOWMAN, ERICA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2800 ASHTON DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2486
Mailing Address - Country:US
Mailing Address - Phone:910-794-8892
Mailing Address - Fax:910-794-8895
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-667-3404
Practice Address - Fax:910-815-5629
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2022-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC104061363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ33421Medicare UPIN
NC2762632Medicare ID - Type Unspecified