Individual
ELLY BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
611 S CREWS AVE, ODESSA, MO 64076-1639
(816) 809-4208
Mailing address
611 S CREWS AVE, ODESSA, MO 64076-1639
(816) 809-4208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2015001689
MO
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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