Basic Information
| Provider Information | |||||||||
| NPI: | 1619567666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWDEN | ||||||||
| FirstName: | ANGEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | AGNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1971 | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283291971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103797687 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2150 HULL RD | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285042052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009799595 | ||||||||
| FaxNumber: | 2486629845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2021 | ||||||||
| LastUpdateDate: | 01/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 5013991 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.