Provider Demographics
NPI:1730800095
Name:BOWEN, BRITTNEY (CRNA)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:WOLFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:560 TAURUS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-9226
Mailing Address - Country:US
Mailing Address - Phone:419-467-1604
Mailing Address - Fax:
Practice Address - Street 1:1000 WATERMAN WAY
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5266
Practice Address - Country:US
Practice Address - Phone:419-467-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9470620163W00000X
FLAPRN11026208367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9470620OtherNURSING LICENSE
FLAPRN11026208OtherAPRN LICENSE