Provider Demographics
NPI:1366565186
Name:BOWMAN, RACHEL JENNIE
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:JENNIE
Last Name:BOWMAN
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 1:124 SCHELLINGER AVE
Mailing Address - Street 2:
Mailing Address - City:VILLAS
Mailing Address - State:NJ
Mailing Address - Zip Code:08251-3039
Mailing Address - Country:US
Mailing Address - Phone:609-770-3474
Mailing Address - Fax:
Practice Address - Street 1:124 SCHELLINGER AVE
Practice Address - Street 2:
Practice Address - City:VILLAS
Practice Address - State:NJ
Practice Address - Zip Code:08251-3039
Practice Address - Country:US
Practice Address - Phone:609-770-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA08171753376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide