Provider Demographics
NPI:1982790515
Name:BOWER, ANNA L (APRN, PSYCHIATRY LMF)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:L
Last Name:BOWER
Suffix:
Gender:F
Credentials:APRN, PSYCHIATRY LMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 CORNWALLIS LANE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-922-1262
Mailing Address - Fax:219-922-1262
Practice Address - Street 1:931 CORNWALLIS LANE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-922-1262
Practice Address - Fax:219-922-1262
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000181A106H00000X
IN70000155A364SP0808X, 363L00000X
IN70000155B364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INQ12125Medicare UPIN
INM400030482Medicare PIN
Q12125Medicare UPIN