Individual
MARY BETH BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 320-3911
Mailing address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024169811
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282NC0060X
—
VA
Enumeration date
09/04/2012
Last updated
09/04/2012
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