Individual
LAURA BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-6706
(478) 633-5384
Mailing address
598 3RD ST, MACON, GA 31201-3357
(478) 633-6706
(478) 633-5384
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN080649
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000866841D
PEACHSTATE CMO - MCCG
GA
05
—
000866841D
—
GA
01
—
430076810
RAILROAD MCR - MCCG
GA
Enumeration date
06/04/2007
Last updated
07/08/2007
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