Individual
JASON BROCK BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-3170
(505) 727-9590
Mailing address
500 WALTER ST NE STE 501, ALBUQUERQUE, NM 87102-2521
(505) 727-5144
(505) 727-9467
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R63343
NM
363LA2100X
Acute Care Nurse Practitioner
Primary
73279
NM
Other
Enumeration date
05/26/2022
Last updated
06/07/2023
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