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Individual
MS. LARAINE REIBSON BOWEN
Active
Individual
MS. LARAINE REIBSON BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04602
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCH780E
MEDICARE
NC
Enumeration date
09/14/2006
Last updated
05/24/2017
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