Melissa Denise Bowman, LPN

Individual provider Active NPI Licensed Practical Nurse · Vicksburg, MS

NPI 1619639895 · NPPES record last updated Oct 6, 2021

Key facts

NPI
1619639895
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
315623 (MS)
Practice address
3442 Wisconsin Ave
Vicksburg, MS 39180-5331
Phone
(601) 634-0181
NPI assigned
Oct 6, 2021
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
315623MSMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 315623 MS Yes

Addresses

Primary practice location

3442 Wisconsin Ave
Vicksburg, MS 39180-5331

Mailing address

3442 Wisconsin Ave
Vicksburg, MS 39180-5331
Phone (601) 634-0181

Other providers in Vicksburg, MS

All providers in Vicksburg, MS · Licensed Practical Nurse in Mississippi

Sources for this page

Verify at the official NPI Registry.