Provider Demographics
NPI:1548387053
Name:BOWEN, JOANNE M (RN)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:BOWEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3864
Mailing Address - Country:US
Mailing Address - Phone:708-484-0347
Mailing Address - Fax:708-401-0446
Practice Address - Street 1:3605 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3864
Practice Address - Country:US
Practice Address - Phone:708-484-0347
Practice Address - Fax:708-401-0446
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care