Provider Demographics
NPI:1265793673
Name:BOWMAN-SCUTT, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BOWMAN-SCUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 MARYBELLE RD
Mailing Address - Street 2:
Mailing Address - City:TULLY
Mailing Address - State:NY
Mailing Address - Zip Code:13159-3257
Mailing Address - Country:US
Mailing Address - Phone:607-591-3149
Mailing Address - Fax:
Practice Address - Street 1:7534 E KEENEY RD
Practice Address - Street 2:
Practice Address - City:CUYLER
Practice Address - State:NY
Practice Address - Zip Code:13158-3198
Practice Address - Country:US
Practice Address - Phone:607-591-3149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304978164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse