Individual
TRACI D BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 DUPREE RD, OLIVE BRANCH, MS 38654-8680
(662) 772-6417
Mailing address
4600 DUPREE RD, OLIVE BRANCH, MS 38654-8680
(662) 772-6417
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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