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Individual

SUSAN LYNN BOWMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4095 LYTLE RD, WAYNESVILLE, OH 45068-8396
(937) 657-6001
Mailing address
4095 LYTLE RD, WAYNESVILLE, OH 45068-8396

Taxonomy

Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
RN161941
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0177891
OH
Enumeration date
08/17/2017
Last updated
08/17/2017
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