| NPI | 1205467677 |
|---|---|
| Former Name | MARIAH BOWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017424) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9411135) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2025-01-14 |