Individual
DEANNA KIM BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1110 N BUCKNER BLVD STE 102, DALLAS, TX 75218-3498
(214) 660-2020
(214) 660-2017
Mailing address
1110 N BUCKNER BLVD STE 102, DALLAS, TX 75218-3498
(214) 660-2020
(214) 660-2017
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
501464
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
501464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166253803
—
TX
05
—
166253804
—
TX
05
—
166253805
—
TX
01
—
NP7208
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/10/2006
Last updated
09/02/2009
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