Provider Demographics
NPI:1831567908
Name:BOWDEN, TIA NICOLE (ARNP)
Entity type:Individual
Prefix:MS
First Name:TIA
Middle Name:NICOLE
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 NE 8TH AVE
Mailing Address - Street 2:#20 D
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5853
Mailing Address - Country:US
Mailing Address - Phone:561-702-6625
Mailing Address - Fax:561-278-4628
Practice Address - Street 1:2015 OCEAN DR STE 11
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5131
Practice Address - Country:US
Practice Address - Phone:561-364-8056
Practice Address - Fax:561-364-8507
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9267676363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology