Diane Sue Bowman, RN
Individual provider Active NPI Registered Nurse · Modesto, CA
NPI 1376691808 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376691808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 397610 (CA)
- Practice address
- 1540 Florida Ave
Ste 100
Modesto, CA 95350 - Phone
- (209) 544-3236
- Fax
- (209) 577-8125
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 397610 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctors Medical Center of Modesto | Past | Accepting new patients | |
| Valley Heart Associates Medical Group Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 397610 | CA | Yes |
Addresses
Primary practice location
1540 Florida Ave
Ste 100
Modesto, CA 95350
Mailing address
1540 Florida Ave
Ste 100
Modesto, CA 95350
Phone (209) 544-3236
Other providers in Modesto, CA
- Susan Ann Bower
- Frank W Bowerman
- Gregory P. Bowerman
- Courtney Marie Bowers
- Michael Bowlin
- Ericka Bowman I
- Robert Bowman
- Tristan Bowman
- Johnny Bowrey
- Madison Boyatt
All providers in Modesto, CA · Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.