Provider Demographics
NPI:1750604047
Name:BOWMAN, ELIZABETH J (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:J
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LILAC RD
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2009
Mailing Address - Country:US
Mailing Address - Phone:631-288-4807
Mailing Address - Fax:631-288-1473
Practice Address - Street 1:50 LILAC RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2009
Practice Address - Country:US
Practice Address - Phone:631-288-4807
Practice Address - Fax:631-288-1473
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY433312-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse