Provider Demographics
NPI:1801376710
Name:BOWLES, DEBRA S
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:BOWLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:S
Other - Last Name:BOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LYONS; HELWIG
Mailing Address - Street 1:7521 BRAYTON DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2667
Mailing Address - Country:US
Mailing Address - Phone:907-717-8808
Mailing Address - Fax:
Practice Address - Street 1:7521 BRAYTON DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2667
Practice Address - Country:US
Practice Address - Phone:907-717-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK000000OtherNO MEDICAID ID # YET