Provider Demographics
NPI:1952566606
Name:BOWMAN, CANDICE COOK (RN)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:COOK
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 1:3655 NEWCREST PT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2031
Mailing Address - Country:US
Mailing Address - Phone:858-509-1516
Mailing Address - Fax:
Practice Address - Street 1:3655 NEWCREST PT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2031
Practice Address - Country:US
Practice Address - Phone:858-509-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562651163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse