Provider Demographics
NPI:1255018727
Name:BOWLIN, AMBER LEA (MSN, APRN, NP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEA
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEA
Other - Last Name:BRYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10740 TRENTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-4423
Mailing Address - Country:US
Mailing Address - Phone:804-647-4691
Mailing Address - Fax:
Practice Address - Street 1:2000 WILKES RIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7632
Practice Address - Country:US
Practice Address - Phone:804-877-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0024187604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program