Basic Information
| Provider Information | |||||||||
| NPI: | 1114975323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWEN | ||||||||
| FirstName: | LORRIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | MHS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 191 BILTMORE AVENUE | ||||||||
| Address2: | ASHEVILLE GASTRENTEROLOGY ASSOCIATES, P.A. | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503628 | ||||||||
| Practice Location | |||||||||
| Address1: | 191 BILTMORE AVENUE | ||||||||
| Address2: | ASHEVILLE GASTROENTEROLOGY ASSOCIATES, P.A. | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 02/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 50-000680 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0010-01730 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 50.000680 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 95005443 | 05 | KY | MEDICAID |