Basic Information
Provider Information | |||||||||
NPI: | 1932279429 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BOWSER | ||||||||
FirstName: | AMY | ||||||||
MiddleName: | LYNN | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | APRN, ANP-C | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 131 SAUNDERSVILLE RD | ||||||||
Address2: | SUITE 160 | ||||||||
City: | HENDERSONVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 370758903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6158243737 | ||||||||
FaxNumber: | 8555404722 | ||||||||
Practice Location | |||||||||
Address1: | 405 STEAM PLANT RD | ||||||||
Address2: | SUITE 200 | ||||||||
City: | GALLATIN | ||||||||
State: | TN | ||||||||
PostalCode: | 370663027 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6158243737 | ||||||||
FaxNumber: | 8882950304 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/09/2006 | ||||||||
LastUpdateDate: | 08/31/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN000010654 | TN | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   | 363LA2200X | APN000010654 | TN | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 163W00000X | RN143885 | TN | N |   | Nursing Service Providers | Registered Nurse |   |
ID Information
ID | Type | State | Issuer | Description | 3341488 | 05 | TN |   | MEDICAID | 0231828 | 01 | WA | WASHINGTON STATE DEPARTMENT OF LABOR | OTHER | 62-1825612 | 01 | TN | HUMANA CHOICE CARE | OTHER | 621825612 | 01 | TN | SIGNATURE HEALTH ALLIANCE | OTHER | 621825612 | 01 | TN | USA MCO | OTHER | SSN | 01 | TN | HUMANA MILITARY - TRICARE STANDARD-SOUTH REGION | OTHER | 62-1825612 | 01 | TN | CIGNA HEALTHCARE | OTHER | 621825612 | 01 | TN | UNITED HEALTHCARE | OTHER | 621825612 | 01 | TN | CENTER CARE | OTHER | 621825612 | 01 | TN | PRIME HEALTH SERVICES | OTHER | 4173209 | 01 | TN | BCBS | OTHER | 621825612 | 01 | TN | BLUEGRASS FAMILY HEALTH | OTHER | SSN | 01 | TN | HEALTH NET FEDERAL SERVICES | OTHER | 62-1825612 | 01 | TN | EMPLOYERS HEALTH NETWORK | OTHER | 621825612 | 01 |   | BEECH STREET | OTHER | SSN | 01 | TN | HUMANA MILITARY - TRICARE PRIME | OTHER |