Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 812985 | NV |
N | 363LG0600X | Nurse Practitioner - Gerontology | 812985 | NV |
NPI | 1083197644 |
---|---|
Provider Name | Ms. Brynja Bowman |
First Address | Reno, NV 89503-2724 |
Second Address | Reno, NV 89502-1576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2018 |
Last Update Date | 25/03/2019 |