Provider Demographics
NPI:1144107525
Name:NOBLE BOWER, TRAVON ALEXANDER
Entity type:Individual
Prefix:
First Name:TRAVON
Middle Name:ALEXANDER
Last Name:NOBLE BOWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 N SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3934
Mailing Address - Country:US
Mailing Address - Phone:402-831-0525
Mailing Address - Fax:
Practice Address - Street 1:914 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3934
Practice Address - Country:US
Practice Address - Phone:402-831-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion