Provider Demographics
NPI:1669712378
Name:BOWEN, CHELSEA (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5975 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-5826
Mailing Address - Country:US
Mailing Address - Phone:304-881-3855
Mailing Address - Fax:
Practice Address - Street 1:265 BROOKVIEW CENTRE WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4049
Practice Address - Country:US
Practice Address - Phone:865-693-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY96900030Medicaid