Provider Demographics
NPI:1952024259
Name:BOWLER, COURTNEY A (APRN-CNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:BOWLER
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-C
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ALYSIA
Other - Last Name:BOWLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-CNP, FNP-C
Mailing Address - Street 1:1605 MILL CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-7191
Mailing Address - Country:US
Mailing Address - Phone:405-570-2803
Mailing Address - Fax:
Practice Address - Street 1:901 S AIR DEPOT BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4836
Practice Address - Country:US
Practice Address - Phone:405-757-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210375363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care