Provider Demographics
NPI:1467298794
Name:BOWMAN, DENEEN D (FNP)
Entity type:Individual
Prefix:
First Name:DENEEN
Middle Name:D
Last Name:BOWMAN
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1250
Mailing Address - Country:US
Mailing Address - Phone:315-598-7105
Mailing Address - Fax:
Practice Address - Street 1:188 HAWK RD
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4497
Practice Address - Country:US
Practice Address - Phone:315-297-9109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593128163W00000X
NY354709207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse