Provider Demographics
NPI:1750875753
Name:BOWMAN, REBECCA SUE (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
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 1:98-629 KILINOE ST APT 2A2
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-2196
Mailing Address - Country:US
Mailing Address - Phone:808-349-9308
Mailing Address - Fax:
Practice Address - Street 1:98-629 KILINOE ST APT 2A2
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-2196
Practice Address - Country:US
Practice Address - Phone:808-349-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI55774163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical