Provider Demographics
NPI:1730563719
Name:BOWLES, LINDSEY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:BOWLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:LINDSEY
Other - Middle Name:DEVAN BOWLES
Other - Last Name:SHANHOLTZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:337-991-9276
Mailing Address - Fax:337-943-0846
Practice Address - Street 1:30 MON HEALTH DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2853
Practice Address - Country:US
Practice Address - Phone:337-991-9276
Practice Address - Fax:337-943-0846
Is Sole Proprietor?:No
Enumeration Date:2015-07-19
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014625363LF0000X
OHAPRN.CNP.0027270363LF0000X
WVAPRN79599-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily