Provider Demographics
NPI:1336803121
Name:BOWMAN, ZOPHEA
Entity Type:Individual
Prefix:
First Name:ZOPHEA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 ALBEMARLE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-4660
Mailing Address - Country:US
Mailing Address - Phone:304-960-3531
Mailing Address - Fax:
Practice Address - Street 1:641 ALBEMARLE ST APT 2
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-4660
Practice Address - Country:US
Practice Address - Phone:304-960-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide