Basic Information
| Provider Information | |||||||||
| NPI: | 1821454190 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWDEN | ||||||||
| FirstName: | BRIANA | ||||||||
| MiddleName: | SARAH | ||||||||
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| Credential: | ANP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SMITH | ||||||||
| OtherFirstName: | BRIANA | ||||||||
| OtherMiddleName: | SARAH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9 CAREY RD | ||||||||
| Address2: | |||||||||
| City: | QUEENSBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128047880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187610300 | ||||||||
| FaxNumber: | 5188242388 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 FAIRFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | SCHROON LAKE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128700292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185327120 | ||||||||
| FaxNumber: | 5185320593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2016 | ||||||||
| LastUpdateDate: | 10/10/2018 | ||||||||
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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 | 363LA2200X | F307301 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.