Individual
MS. NICOLE M BOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5500 BROOKTREE RD, STE 201, WEXFORD, PA 15090-9260
(724) 933-1420
(724) 933-1439
Mailing address
5500 BROOKTREE RD, STE 201, WEXFORD, PA 15090-9260
(724) 933-1420
(724) 933-1439
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
890
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3374865
—
TN
Enumeration date
06/22/2005
Last updated
03/24/2009
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