Elizabeth Yun Bowman, IDC

Individual provider Active NPI Independent Duty Corpsman · Tinker Afb, OK

NPI 1154765022 · NPPES record last updated Mar 18, 2022

Key facts

NPI
1154765022
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
7050 Air Depot Blvd
Tinker Afb, OK 73145-8716
Phone
(405) 582-6665
Fax
(405) 736-3619
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

7050 Air Depot Blvd
Tinker Afb, OK 73145-8716

Mailing address

7050 Air Depot Blvd
Tinker Afb, OK 73145-8716
Phone (405) 582-6665

Other identifiers

IdentifierTypeStateIssuer
1710/1002XOtherMILITARY IDC

Electronic endpoints

TypeEndpointUseAffiliation
Other URL www.navy.mil Direct

Other providers in Tinker Afb, OK

All providers in Tinker Afb, OK · Independent Duty Corpsman in Oklahoma

Sources for this page

Verify at the official NPI Registry.