Provider Demographics
NPI:1801492830
Name:BOWERS, HEATHER (FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HUGH RULE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:TN
Mailing Address - Zip Code:37853-3037
Mailing Address - Country:US
Mailing Address - Phone:540-958-4398
Mailing Address - Fax:
Practice Address - Street 1:105 HUGH RULE DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:TN
Practice Address - Zip Code:37853-3037
Practice Address - Country:US
Practice Address - Phone:540-958-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP500002211363LF0000X
VA0024183700363LF0000X
TN28640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily