Provider Demographics
NPI:1952799843
Name:BOWSHER, TANYA MARIE (APN, CNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:MARIE
Last Name:BOWSHER
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:MARIE
Other - Last Name:DOWNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-2116
Mailing Address - Country:US
Mailing Address - Phone:217-762-6241
Mailing Address - Fax:217-761-1702
Practice Address - Street 1:407 S JACKSON ST STE A
Practice Address - Street 2:
Practice Address - City:CERRO GORDO
Practice Address - State:IL
Practice Address - Zip Code:61818-4360
Practice Address - Country:US
Practice Address - Phone:217-763-6010
Practice Address - Fax:217-763-6012
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily