Individual
STACIE BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
4307 MACCORKLE AVE SE, CHARLESTON, WV 25304-2500
(304) 205-6123
Mailing address
103 STATION PLACE WAY, HURRICANE, WV 25526-8747
(304) 205-6123
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
106970
WV
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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