Provider Demographics
NPI:1548353600
Name:BOWIE, EILEEN (CRNP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:BOWIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 S BROAD ST
Mailing Address - Street 2:STE. 300 ATTN: ANGELA MIDDLETON
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1536
Mailing Address - Country:US
Mailing Address - Phone:215-462-7100
Mailing Address - Fax:215-463-3820
Practice Address - Street 1:1703 S BROAD ST
Practice Address - Street 2:STE. 300
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19148-1536
Practice Address - Country:US
Practice Address - Phone:215-462-7100
Practice Address - Fax:215-463-3820
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005765C363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP005765COtherLICENSE #