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Individual

MS. TAMMY M BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACPNP

Contact information

Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 454-2561
Mailing address
1 CHILDRENS PL, CB 8116, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 454-2561

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
100860
MO
363LP0200X
Pediatric Nurse Practitioner
100860
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IL
Enumeration date
04/02/2007
Last updated
11/02/2021
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