Lou Ann Bowen, CRNA

Individual provider Active NPI Anesthesiology Physician · Montgomery, WV

NPI 1295809507 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295809507
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
23413 (WV)
Practice address
401 6TH Ave
Montgomery, WV 25136-0270
Phone
(304) 442-1331
Fax
(304) 442-1324
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23413 WV Yes

Addresses

Primary practice location

401 6TH Ave
Montgomery, WV 25136-0270

Mailing address

316 6TH Avenue
Montgomery, WV 25136-0270
Phone (304) 442-4954

Other identifiers

IdentifierTypeStateIssuer
0066341000MedicaidWV

Other providers in Montgomery, WV

All providers in Montgomery, WV · Anesthesiology Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.