Individual
MS. TRACY BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8928
(252) 399-7477
Mailing address
PO BOX 12156, NEWPORT NEWS, VA 23612-2156
(757) 867-6593
(757) 867-6588
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-06396
NC
363AM0700X
Medical Physician Assistant
001588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043228729
—
NC
Enumeration date
08/04/2006
Last updated
07/10/2018
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