Individual
SUE ELLEN BOWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9507 HOSPITAL AVENUE, NASSAWADOX, VA 23413-0017
(757) 414-8702
(757) 414-8335
Mailing address
9507 HOSPITAL AVENUE, P.O. BO X 17, NASSAWADOX, VA 23413-0017
(757) 414-8702
(757) 414-8335
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R158735
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403673500
—
MD
01
—
430075595
RAILROAD MEDICARE
—
01
—
C00228
CRNA
VA
Enumeration date
11/28/2005
Last updated
02/13/2009
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