Danielle Bowen

Individual provider Active NPI Registered Nurse · Clovis, NM

NPI 1376824904 · NPPES record last updated Sep 9, 2011

Key facts

NPI
1376824904
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN-70786 (NM)
Practice address
1100 W 21St St
Clovis, NM 88101-4151
Phone
(575) 769-2345
Fax
(575) 769-9013
NPI assigned
Sep 9, 2011
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)
No

State licenses

LicenseStateTypeSpecialty
RN-70786NMMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-70786 NM Yes

Addresses

Primary practice location

1100 W 21St St
Clovis, NM 88101-4151

Mailing address

1100 W 21St St
Clovis, NM 88101-4151
Phone (575) 769-2345

Other providers in Clovis, NM

All providers in Clovis, NM · Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.